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Semelhante a Pet Loss Support
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Pet Loss Support
- 1. Pet Loss Support Jo-Ann Fowler Trainer, SCAS
- 2. Pet Loss Support What will we be looking at today? • The human – companion animal bond • Loss and grief • Supporting clients • Pet loss support protocols
- 3. The Human – Companion Animal Bond What is it?
- 4. A Person - Pet Relationship
- 5. The human-companion animal bond “The human-animal bond is a mutually beneficial and dynamic relationship between people and other animals that is influenced by behaviours that are essential to the health and well being of both.” “This includes but is not limited to, emotional, psychological and physical interactions of people, other animals and the environment.” Statement from the AVMA Committee on The Human Animal Bond in JAVMA vol. 212, No. 11, p 1675, June 1, 1998
- 6. People will go to extraordinary lengths for their pets and often will put their pets lives in front of their own safety.
- 9. VIDEO: Louis
- 10. The human-companion animal bond An attachment relationship Loss of a pet can be a very difficult thing for people to cope with
- 11. The human-companion animal bond Who are those that will particularly vulnerable when experiencing the loss of a pet? Why might their bond be stronger?
- 12. The human-companion animal bond When a bond gets stronger • • • • • There are time when I’d be lonely except for my pet My pet gives me a reason for getting up in the morning In many ways my pet is the best friend I have My pet helps me to be more physically active I couldn’t have made it through that difficult time without my pet • My pet is the last link to my late husband/wife/mum/dad • “Special” pets
- 13. The human – companion animal bond Exercise Working with the person sitting next to you, talk for 5-10 minutes about a client and their pet that you have observed and what made their relationship special e.g. shared activities, personality of the pet; Swap over. Then I will ask one or two of you to share your observations with the group.
- 14. Bond-centred Practice: Focuses on people and the relationships they form with: •their companion animals •with each other •with the veterinary professionals caring for their animals (Lagoni, Morehead, Brannan & Butler,2001 )
- 15. A bond-centred practice 10% of owners will see their doctors 15% of owners will take time off work 30% of owners will never go back to that practice Brin McNeill, SPVS Seminar 2007 huge potential loss of income
- 16. Loss and Grief
- 17. Factors that can shape grief in relation to pet loss • Age and life-stage • Context of the loss, life circumstances and individual vulnerability • The circumstances of the loss
- 18. What circumstances can lead to the loss of a pet?
- 19. Loss of a pet • Natural death e.g. heart failure • Accidental death e.g. RTA • PTS – euthanasia almost unique to veterinary medicine • Leaving a violent partner, moving into a hostel – pet could be temporarily fostered • Divorce, separation Mandatory euthanasia e.g. FMD outbreak, Dangerous Dogs Act (1991) • Natural disaster e.g. floods • Theft • Straying • Military transfer • PTS behaviour related • Moving to residential accommodation • Imprisonment •
- 20. Most importantly, the deeper the bond and more special the relationship with the pet, the greater the depth of emotion and grief experienced. But, Never make assumptions on how you think people may react
- 21. VIDEO: ODEN
- 22. Personal patterns and processes Stages of grief • • • • • Numbing / shock / denial Anger / yearning / searching Bargaining Despair / Depression Acceptance / Closure Not linear but chaotic
- 23. Not linear but chaotic
- 24. Loss and Grief Grief is not an illness but a natural response to loss or threat of loss. Physical Emotional/psychological Cognitive (thinking) Social Grief itself is not an emotion
- 25. Grief and Loss Physical Reactions • • • • • • • • Insomnia (not sleeping) Tiredness / lethargy / yawning Crying / sobbing out loud Diarrhoea / vomiting / nausea / change in appetite Agitation (inability to sit still – wringing hands) Muscle tension / body pain Weight on chest / breathlessness Increased heart rate
- 26. Grief and Loss Thinking (Cognitive) • Blame – self or others • Information seeking – about where the animal will go and the new owners “will he be ok?” • Thinking about the animal and talking about the animal, “processing out” • Reliving the event of the separation • Inability to concentrate/focus
- 27. Grief and Loss Emotional / Psychological • • • • • • • Sadness Depression – extreme and overwhelming sadness Shock Anger Denial Guilt/shame Feelings of doubt in relation to making the decision to re-home.
- 28. Grief and Loss Social • Temporary increased dependency or withdrawal from others • Feeling isolated and alone • Loss of identity • Loss of membership of social group
- 29. Anticipatory Grief • Stop/go (planning v giving up hope) • Coping with the effects of an illness • Very difficult living in a state of angst • Stress / anxiety / depression / PTSD • Quality of life debate People may need as much support before as they do after the loss
- 30. Disenfranchised Loss • • • There is generally no compassionate leave from work in relation to pet loss, There are no socially accepted ways of mourning deceased pets, Other people may not respond in a compassionate way, but could merely dismiss a grieving pet owner by suggesting they get another animal.
- 31. 'Phoebe has been found and it's terrible news': A 'devastated' Emma Bunton tweets her sadness over loss of beloved pet dog
- 32. IT'S. A. DOG. Get over it for goodness sake. Really annoys me the way people treat animals like people Dogs are two a penny. Get another one. This seems a little OTT. Anyone would think a child had gone missing! Proof that a dog isn't for life and is just for Christmas after all. Probably in a Tesco burger by now... This is outrageous behaviour from a woman who has children! She should use her brain and try to imagine how people who have missing children will feel when they read of her over the top search for a dog. I'm a dog lover, but this is too much! No big deal, dogs are two a penny It's just a dog
- 33. Heartbreaking, only dog owners will understand RIP Phoebe and every other animal that dies alone Losing a pet is horrible, you grow attachments to them and they become part of the family. I'm sending my love to Emma and her family at this sad time Would everyone stop saying 'its just a dog' and 'what if it were a child'. My dogs are every bit as precious to me as your children are to you. Your children may be the centre of your universe but my children are mine. I would be devastated if anything happened to them as Emma is now So very sad
- 34. Responsibility Grief •Questioning their own motivations •Doubt •Guilt (Responsibility) •Relief => Regret •Undeserving of support => Alone •Trivialise their own feelings
- 35. Supporting the Client What do they need? • Recognition of their loss • Permission to grieve / Permission to stop grieving • To know that you hear and understand what they are telling you • To know that they are not being judged • Opportunity to reflect and question with someone that understands • Information – after-death body care options, how they can check on their pet in its new home, etc
- 36. Supporting the Client Emotional Support Anyone can provide emotional support for a person experiencing distress. Family members, friends, colleagues and professionals can all lend a listening ear.
- 37. Supporting the Client Emotional Support • Focused on the emotional needs of another • Grounded in listening and communicating understanding of what has been expressed • Must be genuine and is non-directive • Informal and unstructured • Essentially very different to counselling (WHY?) • Will involve signposting to others such as PBSS
- 38. Supporting the Client Emotional Support Why is it not counselling? •Counselling is provided by trained, usually registered and supervised individuals working within a therapeutic framework and applying a specific model of counselling •Limited time and sessions •Indemnity Insurance •Measured goals and outcomes •Members of a professional governing body •Counsellors have to work within a code of ethics.
- 39. What form of support to you offer in your practice?
- 40. Supporting the Client Emotional Support Sympathy V Empathy The aims of “person-centred” emotional support are to: •Generate an equal, trusting supportive relationship •Enable and empower those being supported •Be free from judgement and prejudice
- 41. Frame of reference Internal (putting yourself in their shoes – their internal focus … how it is for them) External – staying in your own shoes – outside or external to their own experience … how it might be for you if you were in that position
- 42. Frame of reference A. “I would be completely fuming with any driver who hit my cat” B. “You feel furious towards the driver who injured your cat” A. “I think everything will be ok now” B. “You hope things will be better with this new treatment” A. “I think Rover will be fine swallowing these – most cats are” B.“You are worried that you won't be able to get Rover to swallow the tablets”
- 43. Empathy VIDEO: The power of Empathy
- 44. Barriers to listening • Hearing vs Listening • Not being able to see someone • Cultural differences • Lack of shared vocabulary • Background noise • Distractions • Physical comfort of environment • Mobile phones • Feeling rushed • Own thoughts
- 45. Supporting the Client Communication Words spoken Tone Non-verbal 7% 38% 55%
- 46. Supporting the Client Effective / Active Listening Skills Reflecting Restating Paraphrasing Asking open questions Summarizing • Encouraging phrases – “I see…..” – “Go on….” • Open vs. Closed questions – – – – – Who? What? When? Where? (Why?) • Allow silences/pauses
- 47. Change these closed questions into open questions 1. Were you upset when Oliver became ill? • 2. Did you contact the crematorium about Frisky? • 3. Are you anxious about being present at Lucy's euthanasia? • 4. Is it the cost of home euthanasia that worries you? • 5. Do you want to wait until next week to discuss things further?
- 48. VIDEO: Tessy Examples of active listening skills
- 49. Active listening summary 1. Pay attention: Look at speaker, look at body language, put aside distracting thoughts 2. Show that you are listening: Nod occasionally, use facial expressions, posture open and inviting, small verbal comments such as uh huh 3. Provide feedback: Reflect, paraphrasing, ask questions to clarify points, summarise etc. 4. Defer judgement: Don't interrupt!
- 50. Physical Contact
- 51. Pet Loss Support Protocols Physical Environment Compassionate communication Resources Staff support Self care
- 52. Pet Loss Support Protocols Physical Environment •Quiet room •Somewhere to sit down •Refreshments •Separate Exit •Home euthanasia option?
- 53. VIDEO: In home pet euthanasia
- 54. Pet Loss Support Protocols Resource Materials •Handouts, Website •PBSS information cards, leaflets and posters •Tissues •Envelopes/bags for fur/hair •Sympathy cards
- 56. Pet Loss Support Protocols •Emotional support skills •Pre-bereavement discussions •Payment protocols •Validation of grief Compassionate communication •Referral when appropriate •Follow up
- 57. Pet Loss Support Protocols •CPD •PLS Officer/Co-ordinator •Mentoring scheme •Debriefs in staff meetings •PBSS •Talk about it •Journal •Know your limitations Staff support Self care
- 58. 0800 096 6606 pbssmail@bluecross.org.uk 7 days a week, 8.30am to 8.30pm Trained volunteers listening service Literature
- 59. Pet Loss Support Protocols Reflect upon what things you already have in place What additional things could you put in place?
- 60. Pet Loss Support Further study and reading Pet Loss Support in Veterinary Practice Distance Learning Course (SCAS) Companion Animal Death by Mary F. Stewart, Butterworth-Heinemann Death of an Animal Friend Produced by the Society for Companion Animal Studies (SCAS) Absent Friend by Laura and Martyn Lee, published by Henston Goodbye, Dear Friend by Virginia Ironside, published by Robson Coping with Pet Loss by Robin Grey, Sheldon Press Handbook of Veterinary Communication Skills Edited by Carol Gray and Jenny Moffett
- 61. Pet Loss Support Conclusion Every situation is – unique and very personal We need to be compassionate and caring – to the animals – to ourselves – to colleagues and clients
- 62. Thank you for your attention www.scas.org.uk info@scas.org.uk
Notas do Editor
- Polls
- Mr Jarvis said: ‘He was desperately trying to scramble back on to it, but he couldn’t pull himself up. ‘We were watching his little head sink lower and lower in the water and he was getting tired and slowing down because of the cold. I was thinking, “We’re going to lose the dog – he’s going to die”. I couldn’t let that happen. Read more: http://www.dailymail.co.uk/news/article-2101257/Dog-owner-inched-ice-save-pet-explains-reckless-act.html#ixzz1ousNV7sq
- This was the terrifying moment a brave young mother battled to keep her beloved horse calm as sea water closed in on the animal after he became trapped in mud 'like quicksand'. Exhausted and mud-splattered, Nicole Graham clung to her trapped horse Astro for three hours keeping his head high in a race against the tide. The 78-stone show horse had sunk into quagmire-like mud and was facing the prospect of drowning as the water rose around them. Miss Graham had been out on an afternoon ride with her daughter along the coast near Geelong, south of Melbourne, when 18-year-old Astro suddenly sank into the mud.As her daughter ran to their car and phoned for help, Miss Graham stayed at her horse’s side. She courageously clung on to his neck, terrified that he would not be freed before the tide came in. She said: ‘It was terrifying. It was also heartbreaking to see my horse exhausted and struggling. Play Craig and Louis video to demonstrate a strong and intense bond
- An attachment relationship is generally a mutual and very intense emotional relationship Often used to describe parent-child bond Attachment relationship: The theory of attachment was originally developed by John Bowlby (1907 - 1990), a British psychoanalyst who was attempting to understand the intense distress experienced by children who had been separated from their parents. How many of you have clients / or yourselves refer to your babies?
- The elderly, the young, the lonely, the vulnerable Those that have the support of their pet through a difficult time Where the pet is a link to the past….perhaps a deceased spouse or family member/friend A working dog that has been with its trainer / human for a long time Craig and Loois http://youtu.be/KAn7QbThWAg What are the issues?
- Get them to talk in groups about their experiences and then share some of them within the whole group and discuss the relationship to the HCAB and how different circumstances will affect the bond.
- children of different ages will relate to companion animals differently according to how they conceptualise them, a pet may be like a sibling or a best friend to a child; very young children will be unable to conceptualise the permanence of death; for mid-life pet owners the death of a pony they had from being a teenager can also represent the end of an era and the passage of time; for older people a companion animal may literally be their life-line and the effects of pet loss can be felt at multiple levels. Remember we talked last time about the human-animal bond and how other factors in a person’s life will have a profound affect on the bond they have with their pets and how they are affected by the loss of their pet. The presence of other co-existing losses, past loss history and current personal circumstances. Personal vulnerability factors include being recently bereaved, experiencing developmental life transitions (eg going through puberty or the menopause/andropause), living alone, being child-free, being out of work, having additional physical needs or emotional health difficulties (eg chronic mental illness, additional needs arising from restricted mobility). sudden death is usually always difficult to accept because it is such a shock; accidental death can be traumatic, eg road traffic accidents (RTAs) can be very distressing to witness (sounds, sights and smells) creating more lasting traumatic memories; enforced separations (eg mandatory euthanasia of a dog under the Dangerous Dogs Act 1991) can leave an owner feeling powerless and guilty; some acute medical conditions (eg gastric torsion also known as bloat in dogs or Parvo infection in pups) may be fatal within a few hours; a complicated euthanasia (eg where the vet is unable to raise a vein or the animal struggles) can also have a profound effect on the owner’s grieving process.
- Maybe a pet “needs to be euthanised” because a particular women’s shelter doesn’t take pets….there ARE some that DO…. Helpful for the vet to know. Dogs Trust shelter & RSPCA Residential homes…there are places that do take pets (cinnamon trust – scas pets for life)
- Originally there were five well-known stages of grief as suggested by Elizabeth Kubler-Ross' book, "On Death and Dying." Over last few decades these have really stuck but have been moulded a little – we’re suggesting 5 or 6 stages here but the important thing to remember is that there really is not set plan – it can happen in order, out of order, not at all or everything at once. It will be a personal and unique experience for everyone.
- Lindemann first coined the term in his research circa 1944. Can be seen as: A journey towards the ultimate loss, but is composed of adjusting to the many losses, of the past, present and future. Most associated with death (a chronic illness perhaps) but we should not forget other types of loss will have similar affects on people. Those who were at last week’s webinar will remember the video of Angelo and Simon and the distress that Angelo was going through at the thought of having to give up his beloved Simon. Stop / go – planning for the death and after-death is like admitting there is no hope. Giving up on our loved one. Coping with the effects of an illness……seeing the animal’s demise and feeling helpless, changes in behaviour (an animal may become aggressive which in itself will be distressing for the owner) Small losses along the way as well as the final big loss. Rando (1986) talks of the past, present and future losses of Anticipatory grief. Periods of denial/new hope – followed by more grief when there is a new episode or stage towards the end. This can make people shut down emotionally – they may appear cold or uncaring – they may notice this themselves and then feel confused and guilty about it.
- Pet loss can disenfranchised by nature - Whilst pets are family for closely bonded owners, there are other people perhaps non-pet owners (but NOT always) and others who have a more functional attitude towards companion animals, who will not recognise pet loss as being a significant loss. Pet loss remains unrecognised in society as a bereavement: eg pet funerals can be a source of ridicule, amusement and amazement in the media (considering the animal as replaceable property)
- Question their motivation for the euthanasia, eg was it selfishly motivated or an act of selflessness based on the animal’s needs? Experience doubt with regard to the timing and appropriateness of euthanasia, even in the face of obvious suffering/terminal decline Feel guilty rather than responsible in relation to the euthanasia Feelings of guilt, a grieving owner’s sense of being deserving of other people’s support and understanding, they therefore have periods of feeling intensely alone; this is magnified by them feeling alone with the weight of their responsibility for the euthanasia; when these feelings of guilt change back to acceptance of personal responsibility, owners feel supported, they are able to see that making a decision about euthanasia was in partnership with their veterinary surgeon (they did not make this decision alone, but on clinical advice) and their sense of having a right to seek out support as a legitimate griever increases
- Perhaps many will be looking for answers? But who can tell them the answers? You….? Acceptance is often the key. People do like to share their story…often it really does help to talk about what happened – although for some of course it wont be.
- Providing emotional support is not about entering into a personal friendship with someone in distress, and it is not a counselling relationship - but involves sensitively responding to the emotional needs of another. It does not necessarily involve giving information or advice, but is rather focused on listening and communicating your understanding to the person of their situation.
- Why is it not counselling? Counselling is provided by trained, usually registered and supervised individuals working within a therapeutic framework and applying a specific model of counselling. Limited time and sessions Indemnity Insurance Measured goals and outcomes Members of a professional governing body Counsellors have to work within a code of ethics. Actually whilst in the UK there has been considerable discussion around whether “Counsellor” and “Psychotherapist” should be protected titles under the Health and Care Professions Council….they are currently not protected, which means that legally anyone can still call themselves a counsellor. However, under self regulatory criteria trained counsellors are encouraged to register themselves with a regulatory body – most counsellors are registered with the British Association for Counsellors and Psychotherapists. I should stress that just because you have attended this or other training in how to support people through pet loss it doesn’t make you a counsellor…or in a position to offer pet bereavement counselling – and whilst you may see veterinary practices advertising that they have a resident pet bereavement counsellor – much of the time (not always – some are actually qualified counsellors) much of the time they are not. Why is this important? Most of the time you will be dealing with people who are experiencing “normal” grief responses (in all their variety of individual ways) and for this you can give emotional support and use the skills and knowledge that you have gained from training such as this. However, sometimes, people may be experiencing a complicated or unresolved grief (which we talked about briefly last week). Complicated grief is …..complicated…if it were not complicated it would be called something else….as such there will aspects of support that really only someone with the proper counselling training and experience will be able to deliver effectively. There may also be cases where someone’s grief is being affected by personal pre-diagnosed conditions that you are not aware of. For example – someone that has been suffering from PTSD or clinical depression. In these cases it is important to distinguish between the emotional support that you are able to provide and counselling for which the person will need to consult a registered counsellor – perhaps through their GP or private referral.
- Whilst there is a place for sympathy at times within emotional support provision it is crucial to know the differences between empathy and sympathy. People purely offered sympathy can be left feeling disempowered, disadvantaged and patronised. Involves feeling sorry for the other person Imagining if you were in the other’s position from your own perspective Based on an external frame of reference Empathy is about understanding how they are feeling – and showing that you understand – using an internal frame of reference e.g. You are feeling angry about Nemo’s death NOT I would be feeling angry if I was you NOT I know how you feel - I felt angry when that happened to me last year – it’s about THEM not YOU Free from judgement and prejudice…..is very easy to judge others without looking deeper into why they are behaving in a certain way – or understanding why they did what they did…..especially if we think they actually might be to blame….who are you to judge? Reference to Fenton video. Reference to stories from workshops – catholic lady – man digging up pet
- Often people say to me “I don’t know what to say” – it might interest you to know that > Mehrabian 1967 Other studies have suggested that 60-70% of communication is through body language rather than spoken word.
- Be careful with why? As can be judgemental Beginning and endings important Give warning of having to end Get up and go to the door Offer to continue at a more convenient time Be aware of mismatches i.e. angry but smiling , sad words but laughing.
- Physical contact/touching –only do if you are comfortable Often just a gentle touch on the hand or arm can convey a huge amount that words cannot Appropriate/inappropriate
- Colours – there is a reason that dentists and doctors/hospitals go for pastel shades….calming Bright pictures can be used but avoid specific breeds and species….flowers and scenes may be more appropriate
- Avoid reference to “sleeping” – child needs to understand that the pet will not be waking up and coming back and also that his own normal “sleep” will not result in death. Teachers should be made aware. Parents do know there own children best so don’t “interfere” but where the parents indicate they need some advice – it can be given. A parent has to deal with their own grief as well as that of the child.
- Pre-bereavement discussions: Access to support for anticipatory grief – pre-euthanasia / rehoming discussion about the process.
- Supporting others can be very emotionally draining for yourself – don’t BURNOUT. Its all very well having protocols in place – but if people don’t know WHO is responsible for doing what – it wont work and things get missed and forgotten. PLSO – Useful BUT you are a team – EVERYONE needs to be involved. Duties for a PLSO could be: Writing up pet loss support (PLS) practice protocols – developed and agreed by the practice team Ensuring everyone in the practice, including new staff and non-clinical team members has a copy of the practice pet loss support protocols Taking a mentoring/training role for other staff in PLS ensuring that the principles behind the protocols are understood and acted upon Acting as the first point of contact for PLS related issues Ordering PBSS leaflets, posters and ensuring surgery display for PLS Ensuring a deputy PLSC is appointed Making sure condolence cards are ordered for use in practice Ensuring condolence cards are personally written and sent to a bereaved client ALSO: DO SOMETHING ELSE – do something that does NOT involve supporting people or animals. Even if its just for a few hours a week. Go to the cinema, play sports, go for a walk, go out for dinner, go dancing. Limitations – remember you are NOT a counsellor (unless you are a counsellor of course) – Don’t expect to fix it……
- Make a list – what is possible given your environment – your client needs and your resources available