The paradox of trust in animal hospice & pet loss support

There have been instances in my practice where, during a conversation, an individual who I’m providing pet loss & grief companioning support to expresses difficulty with all manner of issues not directly related to the distant, recent or anticipatory loss of their pet. It’s expected from time to time. And to some degree, it can be linked to the work we’re doing together. It’s often a fine line that I need to carefully consider & be honest with myself about, & so a little curiosity & reflective listening goes a long way. In some cases, its not blurry: the sticky wicket of something like the death of a human loved one, or maybe having a complicated relationship with a human loved one or experiencing conflicts in the workplace has clearly taken a place front & center for the pet guardian—which is actually a pretty common thing to happen when one is wading through the viscous territory of the grief surrounding pet loss, or feeling the effects heavy duty caregiving. Issues that are as significant as the loss of a pet have a tendency to want to come up for air & stretch their legs, too. It’s a deep cauldron. 

My first response is I see you. 

And then, after curiosity enables me to identify if what’s on the person’s mind is out of bounds, as I call it, I offer honesty. 

Because while my training & experience is extensive & well-honed, I’m not a mental health professional. Nor do I want that responsibility. 

There is a level of trust that the kahus that I’m connected to have in me, & sometimes, it’s astonishing, though it shouldn’t be. I’m in the midst of human beings who are navigating the harshest yet most loving of experiences & it lays their emotions bare. I’m often bearing witness to so much. I’m answering the call in the wee hours when something doesn’t seem quite right & next steps need to be sorted. I’m there when something I’ve suggested to try works & a pet guardian’s sense of mastery in caregiving is then bolstered. I’m pivoting & meeting families at the veterinary emergency hospital when something unexpected pops up. I’m in the room in the many instances where uncharted conversations are had with veterinary hospice interdisciplinary team members. And, pet guardians are dealing with other facets of the human condition that, with their big brains & big hearts can leave them raw, weary, vulnerable. Things that they express, like abandonment, poverty of spirit & time & love, conflict with others & themselves, guilt, inadequacy, shame, regret, anger, the absence of what makes them feel whole. 

I’m able to show up when it matters & in a way that resonates. That’s not something that everyone else in a kahu’s sphere can do. And when one is immersed in what feels like quicksand & they feel seen, heard, validated & supported in a way that can’t be found easily elsewhere, the trust that someone feels I’m entitled to is palpable.

But it’s important that I not let my experience & skill to allow me to get over-confident in my abilities. Nor can I allow that or a pet guardian’s trust in me to give me a false sense of license to operate outside of my professional capacity. 

Is the grief associated with pet loss a mental health diagnosis? Surely not. It’s an expected, natural response to a significant life situation. Even when it lingers, because it’s expected to. It’s not something to be cured, fixed, stigmatized or gotten over. It will never not disappear. It feels different as time goes by, & grows around us, & us around it. 

I have, on occasion, needed to be honest & gently reiterate that I’ll not be doing what’s in a pet guardian’s best interests by attempting to counsel them in exploring the other heavy stuff that shows up in our work together & is begging for oxygen. (That situation is no different than when a feature of the pet’s well being needs attention from the veterinarian’s perspective & I quite appropriately assess that’s the case.) And so when I refer a them to another veterinary interdisciplinary team member who does have the skill & professional framework to meet a feature of their needs that I inherently lack the capacity to, that doesn’t mean I’m judging the person in front of me. Nor is that an admission of failure on my part, in fact quite the opposite. It’s an act of due diligence in maintaining best practices for the mental & emotional safety of the kahu & myself. Of grace. Of compassion. 

Pet loss & grief companioning, when done really well, is therapeutic & yes, it’s an art. After all, it feels really good to have a safe space to put our words & feelings & emotions, to really be seen & without judgement when we’re grappling with the death of a pet. And it’s no substitute for mental health support when that is needed. 

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice Palliative Care Advocate, and pet loss & grief companioning certified since 2017. She is founder of Telos Companion Animal Services, LLC & can be found at lorrieshaw.com.

Navigating growing pains in the pet insurance industry with facts, perspective

Pet health insurance is a topic that comes up at least a couple of times per week in my work, & that’s no surprise. After well over 20 years participating in various professional capacities adjacent to veterinary medicine, & now working with families as a Certified Animal Hospice Practitioner focused on senior & geriatric care, animal hospice & palliative care support for pets of any age, the involvement of vet care is common. And, of course I’m frequently liaising with other members of veterinary interdisciplinary teams, so I’m part of these conversations when families are moving through decision making. 

I’ve made some interesting observations. 

The first of which is that pet guardians understand that they can expect a better experience in meeting the changing needs of their pets, no matter the life stage or health status. That’s due to advances made in vet med, including testing & treatments that weren’t available even 10 years ago, a better understanding of animal behavior & my wheelhouse: being able to address the needs of aging pets in meaningful ways. Pets are living longer, & better. 

And all of this means to some degree, more interventions from vet teams. 

Aside from the advances in vet med, there have also been changes in the industry as a whole. This includes the encroachment of private equity & its impact. And considering the trend of more specialty, small practices & micro vet practices pushing back & still having a robust foothold, along with the concierge model gaining traction, families have more options than ever to access the kind of care that makes most sense for them & their pets.

All of this means more spending in this area, along with higher costs. For that reason, families find pet health insurance to be attractive. Even after roughly 20 years of this option being available, pet guardians who’ve signed on for a policy still have flexibility in decision making when they need to regarding diagnostics & treatments recommended by their veterinarian. That differs from human medicine, where health insurance companies may dictate choices.

There are inherent problems with pet health insurance. One part of the equation is driven by consumer behavior. 

Many pet guardians who feel that purchasing a policy is a good investment when their pet is young & healthy quickly lose their enthusiasm with the idea since they’re not getting a lot of mileage out of that investment of money every month because the need to file a claim is pretty rare. So, they opt out early, within a year or two. And with an insurance company having fewer of those consumers participating, but retaining the ones who’ve seen the value in sticking with it—think those with pets with chronic conditions, or when a surgery, hospitalization or palliative & hospice care is needed—& they file claims that cost the company money. And that, from the perspective of the company, isn’t necessarily sustainable. So premium prices increase. Sometimes unfairly so, according to pet guardians. Even some of those in my sphere. 

And if those price increases & other decisions don’t provide a level of sustainability that makes good sense in the eyes of the company, then they sometimes decide to pull the product from their offerings. And that can mean cancelling policies, which hits pet guardians hard. Nationwide did this in 2024, when it nixed over 100,000 policies. That decision is being litigated. Situations like this are especially impactful when families have paid premiums over a period of years & then have a pet whose needs have increased to a point that they would finally see a return on that investment of money, as they see it, by way of having those claims paid—or at least in part.

Another factor to consider is there have been advances in vet med, those have understandably fueled a hike in prices. Coupled with ongoing rate increases needed to keep these services available (reflecting staff compensation that’s more appropriately aligned when it had lagged behind, increasing practice overhead costs, & more), along with inflation, pet health insurance companies say this supports their decision to raise premiums. 

Private equity has seized the opportunity to take a seat at the vet med table, not to mention in the pet health insurance industry, & that’s changed the landscape. German investment firm JAB Holding Co. has ventured into both. The firm owns National Veterinary Associates, with over 1000 general and specialty practices in North America. In recent years, JAB expanded its portfolio to include several pet health insurance offerings. 

Is pet health insurance here to stay? I think it’s fair to say that it is. 

But that’s only more likely if consumers feel like it's a good investment that even if it doesn’t feel like it’s paying off initially, it’s there when a crisis hits. And when a previously healthy pet is diagnosed with something like chronic skin allergies, liver disease, treatable cancer or they need to be hospitalized or have surgery—trust me, the list goes on & on—they’ll heave a sigh of relief. In many cases, I feel like it’s not a matter of if but when. And I can say for certain that the families I’m connected to who are moving through decision making with palliative care, hospice, end of life & euthanasia care (yes, some pet health insurance covers these care options, at least in part), they’re grateful to have some of the financial burden lifted so they can focus on what’s most important. And so, families report there are companies that they’ve have good experiences with. 

Want to tap into a resource that can help you sort through which pet health insurance is best for your own pet? Pet Insurance University, spearheaded by Frances Wilkerson, DVM, provides a comprehensive guide to do just that. 

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is founder of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.