Topic 5.4 Palliative Care, Hospice Care and End-of-Life Planning

Every assistance animal eventually reaches the final stage of life. While this can be an emotionally difficult topic, proactive end-of-life planning is an important component of responsible assistance animal practice. Preparing for this stage allows handlers, families and professionals to focus on maintaining the animal’s comfort, dignity and quality of life while reducing the need to make difficult decisions during times of crisis.

End-of-life planning is not about giving up on an animal. Rather, it is about recognising when the goals of care shift from extending life to maximising comfort, minimising suffering and supporting the wellbeing of both the animal and the people who care for them.

Understanding Palliative Care and Hospice Care

Palliative care aims to improve quality of life for animals living with life-limiting or progressive illness. It focuses on managing pain, controlling symptoms, maintaining comfort and supporting emotional wellbeing, regardless of whether treatment for the underlying condition continues.

Hospice care is a form of palliative care provided when an animal is approaching the end of life and curative treatment is no longer appropriate or desired. The emphasis shifts entirely to comfort, dignity and supporting both the animal and their family through the dying process.

Many assistance animals can continue to enjoy meaningful time with their families while receiving palliative or hospice care. The goal is not necessarily to prolong life, but to ensure that the life remaining is as comfortable and enjoyable as possible.

Recognising When End-of-Life Planning Should Begin

End-of-life planning should begin well before euthanasia becomes an immediate consideration. Animals living with progressive illnesses such as cancer, heart disease, kidney disease, neurological disorders or advanced arthritis often benefit from early discussions about future care.

Planning early allows handlers to consider available treatment options, establish goals of care and discuss likely disease progression with their veterinarian before urgent decisions are required.

Beginning these conversations early often reduces stress and enables families to make thoughtful, informed decisions based on the animal’s welfare rather than reacting during an emergency.

Assessing Quality of Life

Quality of life should guide every end-of-life decision. While there is no single measure that determines when euthanasia is appropriate, regular assessment helps identify whether an animal continues to experience more good days than bad.

Areas commonly considered include:

• pain and comfort
• mobility
• appetite and hydration
• ability to rest comfortably
• continence
• ability to engage in enjoyable activities
• social interaction
• emotional wellbeing
• response to treatment
• overall enjoyment of life.

Many veterinarians use structured quality-of-life assessment tools to monitor changes over time. Recording observations regularly can help families recognise gradual decline that may otherwise be difficult to appreciate.

The Role of the Veterinary Team

Veterinarians play a central role in supporting assistance animals and their families throughout palliative and hospice care. Regular reviews allow pain management, medications, nutrition, mobility support and nursing care to be adjusted as an animal’s condition changes. Ongoing monitoring also helps families recognise subtle changes in quality of life and supports informed, welfare-centred decision-making.

Many veterinary practices now offer dedicated palliative care consultations and structured quality-of-life assessments to help families understand disease progression, discuss treatment options and prepare for future decisions. Rather than focusing solely on diagnosis or treatment, these consultations provide an opportunity to discuss comfort, wellbeing and what matters most for both the animal and the family.

One example is Rest Your Paws, an Australian veterinary service specialising in veterinary palliative care, hospice care and end-of-life support. Their multidisciplinary team includes veterinarians and counsellors with specialised training in companion animal loss, grief and bereavement. Services include comprehensive quality-of-life assessments, palliative and hospice care consultations, advance care planning, in-home euthanasia, family support and grief counselling before and after the loss of a companion animal.

For many assistance animal handlers, in-home consultations provide significant benefits. Remaining in familiar surroundings often reduces stress for both the animal and the handler, allowing the animal to remain comfortable in a place where they feel safe. Home visits also provide families with greater privacy, flexibility and time to say goodbye without the pressures that can sometimes accompany a busy veterinary clinic.

Quality-of-life consultations are valuable even when euthanasia is not yet being considered. They help families understand their animal’s current welfare, identify ways to improve comfort and develop a plan for monitoring changes over time. These discussions can reduce uncertainty and help ensure that future decisions are based on the animal’s welfare rather than delaying difficult decisions because of fear, guilt or uncertainty.

Importantly, specialised end-of-life services recognise that losing an assistance animal is not simply the loss of a pet. For many handlers, it represents the loss of a trusted partner, a source of independence, emotional support and occupational participation. Access to professionals who understand both animal welfare and the profound human–animal bond can provide invaluable support during one of the most difficult stages of the assistance animal partnership.

Advance Care Planning

Advance care planning involves making practical decisions before they become urgently needed. Although these conversations may feel uncomfortable, they often reduce anxiety by ensuring family members understand the animal’s care preferences and have time to consider available options.

Topics to consider include:

• treatment goals
• acceptable interventions
• circumstances in which euthanasia may be considered
• preferred location for euthanasia
• who should be present
• transport arrangements if required
• emergency contacts
• after-death care.

Advance planning allows decisions to be guided by the animal’s welfare rather than emotional distress during a crisis.

Planning for Euthanasia

Euthanasia is one of the most compassionate gifts that can be offered to an animal experiencing unrelievable suffering. Modern veterinary euthanasia is designed to provide a peaceful, painless and dignified death when quality of life can no longer be maintained.

Planning ahead allows families to make choices that reflect both the animal’s needs and their own preferences.

Some families prefer euthanasia to occur at home, where the animal can remain in familiar surroundings with minimal stress. Others feel more comfortable attending their regular veterinary clinic, where staff and equipment are readily available. Neither option is inherently better; the most appropriate choice depends on the individual circumstances.

Families should also consider who they would like present during the appointment. Some people prefer privacy, while others appreciate having family members, close friends or trusted professionals present for emotional support. Some handlers also choose to involve their occupational therapist or another member of their support team if this would assist them during the process.

Creating Meaningful Final Memories

Many families find comfort in intentionally creating positive memories during an animal’s final weeks or days.

These experiences may include visiting favourite places, sharing favourite foods where medically appropriate, spending quiet time together, taking photographs or videos, celebrating the animal’s life or creating a “bucket list” of enjoyable activities.

Some families also choose to create keepsakes before or after death, including:

• ink or clay paw prints
• nose prints
• locks of fur
• photographs
• personalised collars or name tags
• memorial jewellery
• memory boxes
• written reflections or letters.

These activities can provide comfort and help preserve meaningful memories long after the animal has died.

After-Death Care

Planning for after-death care before euthanasia can reduce additional stress during an already emotional time.

Families may choose burial where permitted by local regulations or cremation through a veterinary crematorium. Individual cremation allows ashes to be returned to the family, while communal cremation does not.

For families considering home burial, it is important to think about future housing plans. If relocation is likely, cremation may provide greater flexibility by allowing the animal’s ashes to remain with the family regardless of where they live.

Many families also choose to commemorate their assistance animal through memorial gardens, plaques, framed photographs, planting a tree, charitable donations, artwork or other meaningful tributes celebrating the animal’s contribution, service and companionship.

The Importance of Preparing Emotionally

Although practical planning is important, emotional preparation is equally valuable. Anticipatory grief often begins long before an animal dies and may involve sadness, anxiety, guilt, denial or uncertainty.

Understanding that these emotions are a normal response to the anticipated loss of a deeply valued companion can help families seek support early and reduce feelings of isolation. Having open conversations with family members, veterinarians and other trusted professionals allows everyone to prepare for the final stages of life while keeping the animal’s welfare at the centre of every decision.

The following topic explores euthanasia, grief, bereavement and professional support for handlers following the death of an assistance animal.

Occupational Therapy Considerations

Occupational therapists support handlers throughout end-of-life planning by recognising the profound occupational and emotional significance of assistance animal partnerships. They can facilitate advance planning, encourage collaborative discussions with veterinary professionals, prepare handlers for changing support needs and assist with maintaining participation as the animal’s health declines. Occupational therapists can also help individuals access appropriate community supports, including specialised veterinary palliative care and bereavement services where required. By approaching palliative care and end-of-life planning proactively, occupational therapists help ensure that decisions remain centred on the animal’s welfare while supporting the handler through one of the most significant transitions of the assistance animal partnership.