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Grief is the price one pays for love: it is an intense emotional suffering caused by loss, disaster, misfortune; a deep sense of sadness; pain. Grief leads to mourning which is the expression of grief (the act of working through the pain).
Grief and mourning, as well as death, are inevitable parts of pet ownership.
The human-animal bond is broken in many ways. Pets develop acute or chronic illnesses, are victims of accidents, or die of old age. Pets are also lost or stolen, given up for adoption, or euthanized due to unresolvable behavior problems. Whatever the circumstances, broken bonds create feelings of loss.
Pet loss is a socially negated and trivialized loss. Consequently, feelings of grief are often short-circuited, stuffed, and denied. In Western culture, there are no socially sanctioned ways to mourn the loss of companion animals. This is due, in part, to the belief that pets are easily forgotten and replaced. Loss is as traumatic psychologically as being severely injured is physically.
The grieving process is the healing process necessary to recover from loss. Grieving is the normal way to cope with loss. Grieving takes time and is not “over” in a matter of days or weeks. When grief is allowed free expression, the healing time is reduced; when grief is restricted, its manifestations last much longer.
Most people are familiar with the grief model popularized by Elisabeth Kübler-Ross. She identified five stages of grief that dying people experience and labeled them denial (guilt), anger, bargaining, depression, and acceptance.
Another well-known model of grief is Worden’s four tasks of mourning:
- Accept the reality of the loss
- Experience the pain of grief
- Adjust to an environment in which the deceased is missing
- Withdraw emotional energy and reinvest it in another relationship
The counseling principles that will allow the above four tasks to occur are as follows:
- Help the survivor actualize the loss
- Help the survivors identify and express their feelings
- Assist the survivor to live without the deceased
- Facilitate emotional withdrawal from the deceased
- Provide time to grieve
- Interpret “normal” behavior
- Allow for individual differences
- Provide continuing support
- Examine defenses and coping styles
- Identify pathology and, if it exists, refer to mental health professional
Healthy grief is resilient and forward moving. Its underlying direction is from denial and sadness to reconstruction. Dysfunctional grief involves a stopping of mourning or an exaggeration of characteristics of the first three stages of grief. These characteristics become rigid and fixed, persisting over time. Symptomatology can include denial and avoidance of reality, chronic anger and guilt, persistent depression and a prolonged inability to cope with the basic task of living.
The intensity and duration of various stages depend on several factors such as age, personality, and life circumstances of the owner and the bond (don’t forget the special bond surrounding assistance animals).
Human beings are by nature nurturers. People form strong emotional attachments with their pets and these attachments are sometimes very special and different from the ones they form with people. Animals serve as a source of unconditional love and support (something that is virtually impossible to obtain from another human being for thinking always gets in the way), comfort, safety, security, fun and laughter, and stability. Pets have distinct personalities and habits and are often considered friends and family members.
As reported in the Journal of American Veterinary Medical Association, clients rate the understanding and respect they receive from their veterinarians with regard to their feelings about their pets as more important than the medical treatment provided.
Some startling statistics: 76% of all companion animals are euthanized; over 75% of pet owners experience difficulties and disruptions of their lives after a pet dies; 40–50% of clients who switch veterinarians do so because of dissatisfaction with the circumstances surrounding the deaths or euthanasias of their pets; and 15% of former pet owners say they won’t get another pet because “the death of the pet is too difficult psychologically.”
Veterinary professionals confront loss on a daily basis as they diagnose, treat, and euthanize companion animals. Knowing how to intervene in crises, facilitate decisions, prepare for euthanasias, and normalize the grief process can help change negative experiences into meaningful ones for pet owners and veterinarians alike.
Pet loss counseling encompasses more than grief counseling. In fact, pet loss counseling takes place before, during, and after the deaths of companion animals.
Its focus is much more than the bereavement process. Pet loss counseling consists of four basic components:
- Emergency intervention
- Decision-making facilitation
- Death and euthanasia preparation
- Grief support and education
The term “counseling” refers to helping people through uncomplicated, normal grief within a reasonable time frame. Some believe that normal grief should not be tampered with, however, in the case of pet loss, many people need “permission” from those they trust to even acknowledge they have feelings of grief.
The key word in pet loss counseling is choice. Veterinarians dedicated to pet loss counseling offer clients choices about being present at euthanasias and about viewing their pets’ bodies if the clients have not been present at the time of death. They also offer choices about necropsy and the disposition of bodies.
Suggested choices about saying good-bye to pets can be particularly meaningful to pet owners when they are given by veterinarians. Suggestions from trusted veterinarians give pet owners permission to say good-bye and let them know their grief is acknowledged and validated. When clients feel they have been offered choices about being involved in their pets’ deaths, they are more likely to feel they have made decisions that were right for them.
The following factors contribute to strong attachments. The human companions of these animals may have a particularly hard time when the pet dies.
- Pets who were rescued from death or near-death
- Pets who got owners through a “hard time” in life
- Pets who were childhood companions
- Pets who are their owners’ most significant sources of support
- Pets who have been anthropomorphized to an abnormal degree
- Pets who are symbolic of other significant people (children who are dead), relationships (previous marriages), or times in owners’ lives (a year spent traveling the country)
- Assistance animals
- Pets who have significant interaction with their owners through extensive training (for obedience, hunting, etc).
Normal Manifestations of Grief
- Physical: crying, sobbing, sighing, aching, fatigue, changes in sleeping habits, a feeling of numbness, a sense of shock.
Intellectual: disbelief, denial, restlessness, confusion, inability to concentrate, visual/auditory/olfactory hallucinations, preoccupation with loss.
- Emotional: sadness, anger, depression, guilt, loneliness, feeling of helplessness, a desire to blame, a sense of relief.
- Social: withdrawal, stress, irritability, anxiety, alienation, feelings of isolation, a desire to move or relocate.
- Spiritual: bargains with God, shaken religious beliefs or strengthened religious beliefs, visions, meaningful dreams, paranormal experiences.
Complicated Grief Responses
Any of the following factors can complicate grief for pet owners:
- Other recent or multiple losses in their lives
- No previous experience with death
- Little or no support from other people
- Generally poor coping skills
- Responsibility for death
- Untimely deaths
- Sudden deaths or slow death after long illness
- Not being present at death or euthanasia
- Witnessing a painful or traumatic death
- Religious convictions
Signs of grief in children include (but are not limited to):
- Physical symptoms (stomach aches, headaches)
- Decline in school performance
- Inability to get along with others
- Spending inordinate amounts of time alone or refusing to be alone
- Attention-getting behavior
- Frequent “accidents”
- A return to bedwetting
- Perfectionist behaviors
- Retreating to a fantasy world
Grieving children are in need of many things. These include unconditional love (no matter what their behavior), constant reassurance that others care, assurance that they are worthwhile, frequent explanations of what happened (the truth, not fictions designed to “protect” children), an active listener who “hears” what the child is saying, help to express or verbalize griefs and fears, to be included (in making decisions, in funerals), to be hugged and held, and any other assistance that is given to adults who are grieving for they may help children also.
Similarities and Differences Between Loss of a Human and Loss of a Pet
I am often asked what the similarities and differences, if any, are between human bereavement and bereavement for a lost pet. I have developed a comparison sheet compiling what I think are the important points.
- Grief occurs when significant love ties are broken — that which gives the most pleasure and enhances our lives the greatest will also, by its loss, cause the most pain and grief. Few things add more to our lives than the love and devotion of a faithful pet. They have no hidden agenda, they are not judgmental, they love unconditionally.
- The same stages of grief apply: denial and isolation, anger and guilt, bargaining, depression, and acceptance.
- People suffering from the loss of a companion animal must be allowed time to heal and incorporate the loss into their lives — one never truly “gets over” the loss of a loved one. People must be urged to accept their grief as normal and healthy.
- Those who lose a companion animal have as much a right to say “good-bye” as those who lose a human loved one. It is essential that the bereaved pet owner be encouraged to carry out the necessary rituals of “letting go.”
- Sudden, unexplained deaths are the worst to accept especially if the animal is young or middle-aged.
- Death of an animal that may be the last connection to another significant other that has previously died or left and that previous death or departure is grieved over once again, sometimes even more deeply.
- The painful feelings of sadness will recur after the initial grieving period is over (for example, on birthdays, holidays, anniversaries, visiting favorite places or experiencing certain situations).
- Unlike other areas where loss and death occur, the grief and pain felt at the loss of a beloved pet is little understood, and only limited guidance and comfort has been available. Grief over the loss of a pet is not totally accepted by society. The general response is “Stop crying and just go get another animal to replace it” or “It was just a dog (cat).” These statements are inappropriate. Would you go out and get another husband or wife? Why would you tell someone to just go out and get another animal? You can never “replace” one animal with another — they are as unique and individual as we humans. Statements such as this tend to make the grieving person feel guilty and stupid for feeling sad and upset. This only adds to the problem. Animals are not “its” — they are living, breathing, sentient animals just as we humans are.
- We humans can legally choose to actively euthanize our animals. This is accepted by society. This causes tremendous emotional turmoil — guilt, questions, playing God, waiting for signs, and anticipatory grief.
- People have a hard time acknowledging the fact that our animals are so very important to our physical and mental well-being. This denial causes emotional confusion and turmoil.
- Many people have a difficult time wondering where their animals go after death — many of us believe that human loved ones have heaven, but where do the animals go? Many people state that they want the peace of mind in knowing that they will see their animals again in heaven. (I remind them that as far as the Bible is concerned, God only threw the humans out of paradise.)
The following excerpt from an editorial written by Bill Hall of the Lewiston Tribune illustrates No. 3 above:
When you stop to think about it, it’s odd that human beings develop such a deep bond of affection with dogs and cats. We don’t have that much in common. Ballerinas and truck drivers don’t usually hang around together, nor do rocket scientists and newspaper columnists. Yet they have far more in common with each other than they do with dogs or cats. Nonetheless, people routinely develop deeper bonds of genuine affection with their pets than they do with all but a handful of their fellow human beings. Why is that?
The question came up last week when I lost the best cat I ever knew and felt the pain of his parting as keenly as I would a human friend. And that’s odd. Though we both had hair on our faces and both enjoyed sleeping on the couch, we did not have a great deal in common. We aren’t even the same kind of mammal. How could such a friendship ever bloom? After all, in human relationships, we tend to pal around with people with whom we have something in common — people about as smart as we are, people who like the same hobbies we like, people who enjoy the same jokes we do — people who like us most of all because we are so much like them. There is a lot of self-flattery in our choice of human friends.
But look at my rather typical relationship with a cat: A cat has an IQ of about 3 and mine is at least 10 points higher. A cat eats raw birds and mice and I refuse. A cat is a squat little hairy thing that walks around outside in all kinds of weather on its hands and feet. It drinks out of a toilet. And it breeds in the bushes. No matter what you may have heard, I have done none of that.
So at first glance, a cat isn’t the sort of person you would expect to become friends with, let alone develop a bond of affection that can be broken only with pain. Nonetheless, if you see a man and his cat — a cat and his man — strolling across a yard together, you can plainly see the bond between them in their body language. You can see by the way the cat runs toward the man when he comes home — and from how glad the man is to see his pal — that these two widely diverse creatures are friends, in the full sense of that word, not just in some master-pet arrangement.
“And when the cat dies in one of these cross-species friendships, the grief is sharp and deep — so much so that, when my old pal Sterling died suddenly I was filled with wonder at my own reaction. How could something so different take so big a bite out of my feelings with him when he went?
Special considerations need to be addressed when helping a client make a decision regarding pet euthanasia.
Explore the current conditions of the animal very thoroughly. Determine what the client’s previous experience with euthanasia and/or with death is. Try to determine the client’s religious or philosophical feelings about euthanasia.
Does the animal have any special link to other people in the client’s life? Carefully evaluate the validity of the euthanasia. Can the client provide care of the animal if the animal is not euthanized? Is the client’s quality of life changed because of the animal’s present condition? Can the client afford needed treatment?
In evaluating the validity of the euthanasia, consider the following:
- Is the animal’s condition prolonged, recurring, or getting worse?
- Is the animal no longer responsive to treatment?
- Is the animal in pain or suffering (pain can be relieved, suffering cannot; psychological suffering is as important as physical suffering)?
- If the animal recovers, will the animal be chronically ill and unable to enjoy life?
- If the animal recovers, will there be personality changes?
- And perhaps the most difficult question of all — Am I having trouble with the decisions because I can’t let go? In other words, am I keeping the animal alive for my own sake?
Most people have the greatest difficulty with the idea of active euthanasia, which involves a specific act to terminate life quickly. This procedure is, of course, unacceptable in human medicine.
Active euthanasia, in which there is a conscious decision to terminate a medically compromised life, is unique to veterinary medicine. Euthanasia is killing, and from our earliest years we are taught that killing is wrong. There are many reasons why clients request euthanasia for their pets; some are appropriate reasons while others constitute inappropriate reasons for euthanasia. While the client has the legal right to request euthanasia for a pet, the veterinary professional has the right to refuse if other alternatives that would allow the pet to continue to live a good life might be available.
After a client has decided that euthanasia is the appropriate choice for a pet, the client should be allowed to choose the timing of the euthanasia, to participate in or watch the procedure, to be allowed to see the pet after he/she is dead if the client did not participate in the procedure, and how to take care of the pet’s remains.
Other helpful hints when dealing with euthanasia:
- Avoid the terminology “put to sleep” — parents put their children to sleep every night.
- Explain the procedure fully beforehand.
- Make arrangements for the remains beforehand — encourage closure.
- Make arrangements for payment of the bill beforehand (either prepay or bill later).
- Set aside a time at the end of the work day for euthanasia so clients will not be interrupted or rushed. Arrange for a separate entrance and exit for these clients.
- Allow time with animal alone before euthanasia. Be sure to have Kleenex available.
- Offer the family the opportunity to be present.
- Perform euthanasia with someone else present to not only provide the veterinarian support but also for your client; have a towel present (explain defecation/urination that may occur, explain agonal gasp, consider using a pre-anesthetic and catheter).
- Allow time with animal alone after euthanasia.
- Prepare the body respectfully.
- Use whatever the client supplies or use coffin or box — never use trash bags.
- Help client to their car — allow them their grief — be supportive. Be sure they can drive safely.
- Send card/flowers or call next day.
- Follow up with client who does not return — for what reasons: no pet, angry over something, what?
- Don’t be afraid to do “at home” euthanasia.
Ways to Help Clients
Two of the most effective ways to help your clients is to validate their feelings and encourage them to talk about the loss.
A few other ways to help:
- Don’t belittle the loss.
- Don’t lie, especially to a child.
- Don’t encourage or discourage the acquisition of another pet.
- Don’t scoff at the idea of a ceremony — people need closure and a chance to say goodbye.
- Go over various events and visit places associated with the animal to helping accepting the reality of the loss, looking at pictures, reminiscing about the good and bad times, noting the resemblance of the lost pet to other animals and talking about how the pet enhanced one’s life are excellent ways to help accept the loss.
- Know and communicate to your clients that mourning a pet is natural and normal and nothing of which they should feel ashamed. Clients must give themselves permission to grieve and to accept that mourning takes time.
A short word about veterinarians. Veterinarians must sort out their own feelings toward animal death.
This may be a time when veterinarians must confront a sense of their own mortality; others must confront feelings of failure; still others must confront a desire to either hide their feelings by becoming very professional and cold in dealing with animal death or becoming so involved with each they risk burnout.
A comfortable middle must be found.