Thursday, February 22, 2018

Optimal sleep is a simple way to bolster a pet's palliative or hospice care plan

Ask most people what they could use more of and they'll say, 'sleep'. 

Oh yes, we value it so much and know that we need it to be our best selves. So why is it that so many of us strut around like its a badge of honor to exclaim how little sleep we've had and how productive we are [or think we are]? It's understandable, really, given the current societal climate: if you're not busy most of your waking hours and intrude on those hours when you can rest optimally, you're a loser. That, coupled with a world that's perpetually 'open for business', it's hard to honor our inherent need for sleep, and not just some shut eye, I'm talking about restful, valuable sleep. The truth is, we humans aren't the only ones that need sleep; animals are dependent on it. A new series, "The Secret World of Animal Sleep" on the Smithsonian Earth website, details those parts of the lives of the animal world. 

As a companion animal death doula, and as someone who interacts with senior and geriatric pets regularly, it's hard not to notice that some families have a tendency to impart their own attitudes about rest and sleep onto their pets. Though I see it less often with cats—the assumption that cats sleep their lives away isn't lost on any of us—I'll often hear families lament that their dogs seem to sleep a lot. The truth is, they do, and it's not just growing puppies! 

Older pets, those who are ill or recovering from illness or injury and yes in their twilight or are approaching their end need adequate rest. That said, the standard isn't one-size-fits all. After surgery or an illness of course, it's understandable that recovery takes a lot out of anyone so that's easier to take notice of. What can be more difficult to recognize is when the need tends to build slowly with advanced age and any complicating illness or disease trajectory, as it tends to be more gradual. That, and we might forget how much some daily life and events take out of them: that car ride to relative's house for a fun visit, having a contractor working at the house—even a new arrival like a baby or another pet. 

One of things that I've seen unfold time and time again is a scenario that can get easily overlooked: the need for predictability and routine with our companion animals. It's not all that uncommon on my Monday and Tuesday rounds to find older or hospice pets exhausted, crabby and out-of-sorts. (I also note higher incidences of digestive upset and nausea, but I digress.) For many families, they're away at work and school on weekdays but then on weekends, there's more hustle and bustle around the house, disrupting a pet's usual rest periods, plus there's more inclusion. One astute family pointed this out years ago as their Dalmatian eased into twilight and it's been a barometer I've gratefully employed ever since in my work. 

The point is, any fluctuation in schedule or health status uses physical and mental energy, which can deplete energy stores, so more rest is necessary to cope. And it seems important to remind that things take longer to recover from as age advances.

One thing that I gather from my conversations with families is that it can be a tough pill to swallow, noticing those changes that occur with the age or possible illness of a pet and our need to then admit that's the case. Sometimes, we ignore what we see, so please know it's a normal response to those gut-wrenching realizations but it's something we can and need to hurdle.

What's important to remember is that adequate rest is one of the most helpful, supportive and nurturing things we can offer our pets as they demonstrate to us they're slowly winding down.

In fact, as I've seen in my time in animal hospice, pets tend to fare better when they've been afforded adequate rest balanced with other aspects of a palliative care plan that's tailored to their needs. One of the questions that I ask families with pets receiving enhanced palliative care or in hospice when we meet is, 'How well are they resting? Are they sleeping comfortably? Are you sleeping?'

So, how can we best help our pets roll with the punches during this time? It's pretty simple. The notion of setting the tone for comfort and a sense of safety along with ensuring that there is time set aside for rest affords them the autonomy to do so.

A bed that accommodates their physical comfort, especially when it comes to arthritis is a great start, along with choosing an area of the home that they feel most comfortable in. Having an amount of privacy that suits them (some pets need to be alone) and an optimal level of quiet helps, too. In fact, a few of my families have found it necessary to give their pet a room of their own, preferably one with a door, to rest undisturbed. This not only achieves a peaceful space in terms of noise, privacy and temperature—the latter can be critical for some animals—but in a household with multiple pets, it's not uncommon for the infirm pet to be bullied or fussed with a bit by one or more others so this offers some protection when things can't be supervised. (I see this more so with cats.) 

Balancing out factors like this can optimize the most important of all, time. Understanding what does work for your pet in terms of how much quality sleep they are requiring, and adjusting for stress, seasonal changes (I find that heat and humidity in the summer and wintertime's snow and cold affects energy levels) and changes in their condition and any accompanying anxiety. Some days, you'll notice that your animal friend is demonstrating that they're up for more engagement and that's terrific! Just know that they'll likely need more rest afterwards, so make room for that.

It's a simple idea, but a good solid rest sets up how the coming hours and even days unfold, and using a more encompassed approach with facilitating sleep can yield more good days and help soften the bumpy ones. An equally great benefit of seeing to it that your pet has the kind of rest that they need is that you'll have a better chance of sleeping well, too—something that we need to be our best for everyone in our life, and also helps support that all important human-animal bond well into a pet's end of life. 

As always, I urge my families to take what they derive from the conversations that we have about sleep and other concerns and talk to their veterinarian about additional options that are appropriate and safe for their companion animal. This can include veterinary-formulated nutraceuticals, herbs, supplements, acupuncture and even pharmaceuticals. 

Lorrie Shaw is owner of Professional Pet Sitting, where she specializes in ancillary pet palliative and pet hospice care support. She is also a Certified Pet Loss and Grief Companion and a member of The Association for Pet Loss and Bereavement as well as the International Association of Animal Hospice and Palliative Care and Pet Sitter International. She tweets at @psa2.

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