Managing pet loss grief and sadness

Pet parent grief is like no other. Supporting pet parents through euthanasia is one of the hardest parts of our jobs. We have all experienced the tremendous sadness of participating in the procedure that ends a pet’s life. No matter where you fall on the belief spectrum behind the right or wrong of euthanasia, I think we can all agree the sadness and emotional turmoil we experience during that event affects us all in some way. The items a veterinary clinic has for a deceased pet – often through a third party – can help a client, such as the author, memorialize beloved pets. Courtesy Rhonda Bell The pet owner’s perspective Owners come to us for that last fateful appointment completely dreading every moment up until they finally say their final, “See you later.” I remember making the call to schedule the appointment for my pug when it was her time, and it was the hardest phone call I’ve ever made. I have worked for 15 years in veterinary medicine in various roles within the practice and I seriously struggled to choke out the words of what that appointment was going to be about and why. Even now, writing this I remember, and it brings tears to my eyes. That pug was my soul dog and it still hurts to grieve her sometimes; other times it’s a happy experience when she comes to mind. As a pet owner, our experiences during the euthanasia appointment can really bond us or break us from our relationship with our veterinarian. My experience, unfortunately, was not as good as I would have liked. It was obvious in those final moments the young doctor was handling my appointment was extremely uncomfortable with a grieving pet owner. Consider being the pet owner walking into that clinic with your pet knowing you won't be leaving with them. Those steps take bravery, strength, emotional fortitude we often take for granted. We work in the practice and we do hard things every day. Grieving owners walk in that door looking for a lifeline; looking for someone to acknowledge their pain and the intensity of sadness they are going through; looking for someone to lend support. Unfortunately, many team members are not experienced handling the deep emotional situations that come up in the veterinary practice daily. Our jobs are unlike any other: We must be extremely happy and helpful during routine care, but then we must also be able to play funeral director and help with the ceremony of a pet’ s death and ushering owners into grief. The practice’s role in supporting – not fixing – client grief There are techniques we can use within the practice to help prevent euthanasia and pet deaths from harming or causing long-term fatigue in clients and ourselves. One of those ways is by helping join pet owners in their grief without internalizing their trauma for ourselves. We need to remember we are not grieving for that pet in that moment, but instead we are empathizing with that owner’s sadness. Leaning into grief and sadness will help the client, the team member, and ultimately the pet in that moment. Acknowledging the deep pain the client is in, as well as our own pain in that moment, will allow us to be more empathetic and sympathetic to the situation. The pet owners’ pain is their pain and grief to manage. Our role is to be present and witness it. We are not there to fix it; we can’t fix it. Protecting ourselves from absorbing trauma after trauma allows us to prolong our own emotional health throughout our careers. It is OK to be sad, and it is OK to grieve. It is a normal human reaction to death, sickness, and sadness. We often fight the tears, we don’t acknowledge the sadness, and we bury what is a totally normal reaction to death thinking we are being professional. Failing to acknowledge the situation, or failing to admit normal emotional reactions, especially in a field we are all driven to because of our connections to animals, is a real disconnect for our clients. Stuffing down those emotions puts tremendous stress within our chest and our hearts, and taking it from appointment to appointment gets emotionally fatiguing. Accepting the knowledge that sickness, death, and sadness are a very big part of the job we do every day will allow us to approach those deep emotions in a healthier way. I would even go so far as to say crying in those appointments is a normal, healthy reaction to the situation you are facing. Other clients will understand the compassion and the heart you have if you are affected by the work you are doing. If we get to where we were unaffected by the work that we do, we need to really evaluate ourselves. Psychologytoday.com offers these self-care tips for helping pet owners deal with the loss of their pet. These tips could also apply to us as the health care team working on that appointment. Set aside time to grieve in your own way and release your emotions. Reflect upon the life shared between yourself and that patient, or encourage your client to reflect upon the life they shared with their pet. Choose a calming practice and use it frequently. Maintain routines with the living animals you have as best as you can. Memorialize the memory and love for your pet. Seek support from understanding friends and relatives. Pet memorial items September 12 is National Pet Memorial Day. There are retail items you can carry year-round to help clients memorialize a beloved pet that passes away, or consider sending one as a complimentary gift to a client. Paw print casts Rainbow Bridge cards Urns and wooden boxes for the pet’s cremains A garden stone (customized or plain) A book by others who have gone through the grieving process. Search Amazon for “Pet loss grief” for many options, including books for children A keepsake box for the pet’s collar, name tag, etc. A journal for the client to process their grief A memorial candle A card with links to local pet loss support groups A personalized picture frame An personalized piece jewelry or keychain. Some jewelry items can include a lock of fur The power of memories The American Veterinary Medical Association (AVMA) shared some similar ideas, but one that stood out to me was, “Continue your relationship through memories.” This could be demonstrated during the next appointment for one of the other pets in the household. Commenting on a fond memory or recalling something funny during an appointment with the pet that has passed would show the client you care, and you do remember them and their pet. Memorializing a pet can take many forms, and the owner can often decide what is the most meaningful for them. In the practice, we can also memorialize pets that were significant to us. Some practices use a candle or a light box they illuminate while that appointment is taking place. This light box is kept on the front desk where other clients can see and know what is happening in this moment for one of their comrades. That symbol shows respect to the pet owner who is currently saying goodbye to their pet, but also shows respect to the clients in the waiting room who wouldn’t want to embarrass themselves by being loud or laughing or joking, completely unaware of the situation. I know of a practice that buys a tree in the memory of the pet and sends the pet owner a certificate saying a tree has been planted in their pet’s honor. I love this idea because it is a thoughtful way to permanently memorialize their treasured family member with something good for the environment. Another practice used to have children’s books to help facilitate the discussion of the loss of a pet. It was intended for parents to be able to sit down and read to their children, and answer questions about why their pet wasn’t at home anymore. We had several requests for this book over the years. Having resources that help our clients and staff learn and deal with not only the euthanasia part of the day, but the conversations that follow within their families are ways we can support our clients through the loss of their pet. The author’s last photo of Sugar, top, when she knew it was time to say goodbye. Below: Beloved pets Sugar, left, and Kona, right. Courtesy Rhonda Bell Assess cremation services Many clinics offer cremation services through a third party. Now that you are reading this and thinking about it, take some time to review the offerings your cremation company has. Not all cremation companies are equal, and there are lots of pet memorial options available we may not be familiar with and, therefore, not sharing with our clientele. This goes back to getting comfortable talking about death and sadness, and helping that client lean into what would be the most meaningful for them to memorialize their pet’s life. My own cremation experience was beautiful, despite the awkward euthanasia appointment itself. The company my veterinarian used was very affordable and packaged her cremains beautifully. The custom box came with her name etched on a little brass plate on top, a paw print and a little poem in a cute little frame that also had her paw print in ink and her birthstone. My dog was a relatively new patient for my vet, so they did\ not have a lifetime of care to emotionally connect with. The cremation company they used really made them look good; they cared for Sugar’s cremains and delivered them back to me in a way that showed me they cared she had been a part of my family. I look at those tokens and trinkets fondly as I think of Sugar and Kona, who is in her own beautiful box beside her sister now. Memorializing and participating in the ceremonies around death is important to us as a culture. However, it can also be harmful to us if we don’t do it in healthy ways. Helping our clients understand how healthy grief and sadness are will help them heal and recover sooner. That is only part of the equation, though. The practice’s role – self care Understanding and educating ourselves on how to be healthy while handling grief and sadness around us, and with our clientele and our own pets will help us prevent such things as compassion fatigue and burnout from this very emotionally taxing career field. It is hard to find the balance, and setting aside the time to learn those coping skills and emotional techniques can help prolong and create an extremely fulfilling career in veterinary medicine. This type of education needs to happen for everyone in the practice – beginning with the receptionist at the front desk who has to check in that crying client, to the technician who has to take the pet out of their client’s arms and take it to the back to prepare it for its final procedure, to the doctor who has to push the medication that will ultimately end that pet’s life – and for everyone in between and everyone that follows. Resources: There are a lot of training programs that do help with this tough topic. I follow the articles of Rebecca Rose with Lap of Love; she spends a lot of time working with caregivers on how to handle grief with their clients. I also recently took an intensive online training course on emotional CPR taught by Dr. Joanna Robson. It was incredible and very eye opening. The techniques being taught help us get comfortable with sitting with others while they are in pain without absorbing that pain for ourselves. If you have not heard of eCPR, I encourage you to check it out. I spent the weekend learning how to lean into sadness and grief, and how to listen to others when they are in emotional crisis. That training left me with the knowledge the responsibility of another person’s sadness or grief does not fall on me to fix. I can lend my support and strength to them without internalizing their pain and grief. This approach to supporting someone in emotional crisis doesn’t only relate to pet owner grief, but any type of crisis. Conclusion Euthanasia appointments really do require some strong, healthy boundaries. In veterinary medicine, we are chronically bad about setting and maintaining healthy boundaries. This is the “royal we,” because I am very much in the same boat as everyone else. The work I did fatigued me and burned me out, and I had to take a step back and do a lot of internal work to be able to come back from it. I also had to own my truth that euthanasia is very hard and very sad, and it truthfully hurt my heart. Participating in the death of an animal is gut wrenching no matter how medically justified. The work we do with euthanasia and grieving pet parents is the most demanding thing there is. There is an emotional price we pay, and if we don’t embrace the knowledge about pain, sadness, and grief, it can swallow us up. We won’t immediately recognize all the effects that one procedure can have on us, especially if we push down, bottle up, and repress the feelings that we naturally have in response to pain and sadness. Ultimately, this could burn out our career candle faster than it should have. Shift your mindset to lean into pain, lean into sadness. Supporting the ceremony, memorializing the life we shared with that pet owner, despite how short of a period of time. Lean in to having some of these difficult conversations about intense emotions with your team. Help coach your receptionists and techs, and sometimes even doctors, on how to talk to and work with a grieving pet parent. Two team members are the first points of contact for that grieving pet owner. That entire euthanasia appointment is where the veterinary-client-patient-relationship can break or be further bonded. Please also remember if your team or a client is really struggling with grief and sadness, help them with additional resources for getting help from a professional grief counselor. There are many online options for mental health care like betterhelp.com and talkspace.com, to name a couple. My biggest problem with loving and having pets is they just don’t live quite long enough. We are stewards of that innocence and unconditional love while they are with us, and as their health care team, we have the honor of helping them. We are also trusted to help the people they loved the most, their owners. Rhonda Bell, CVPM, CCFP, CDMP, is founder and co-owner of Dog Days Consulting, a social media and brand management company. She spent 15 years as a practice manager working the day to day challenges of the veterinary practice and experienced firsthand the stresses, joys, communication dilemmas, and wonders of working in veterinary medicine. She now dedicates her work and energy to helping practices succeed online and to coaching team members with the skills that will hopefully prolong their careers. Resources https://www.avma.org/resources-tools/pet-owners/petcare/coping-loss-pet https://www.psychologytoday.com/us/blog/animal-attachment/201702/7-self-care-essentials-while-grieving-the-death-pet https://www.emotional-cpr.org/

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Managing pet loss grief and sadness

Treating your clients with extra compassion during this challenging time can further bond them to your clinic.

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