Role of technicians in providing veterinary nursing to families (Proceedings)

The veterinary staff sees families and provides care at their moments of greatest worry concerning their companion animals. Perhaps more than anyone, a veterinary technician understands how the animal is deeply interwoven into the family's life. The human hospice movement provides philosophical models for caregiving, whether of humans or animals, that focus on providing care, and offers a patients' bill of rights and goals of caregiving (Hospice Foundation of America, 2009; Lattanzi-Licht, 2001). Advocacy for this healing perspective has also been spearheaded by physician Rachel Remen (1996, 2001) in books and teaching. Whether, dog, cat, horse, mouse, or rabbit, the animal assumes its special role today in the home and the fabric of the family. A wide range of research literature on this subject can be accessed at the website of the Program for Companion Animal Behavior at the University of California, Davis, http://www.vetmed.ucdavis.edu/CCAB/main.htm

Compatibility with companion animals

From the moment of first excitement of having a new animal, or even in planning for it beforehand, the veterinary practice can work with the person or family to enhance the relationship and avoid behavior problems before they arise. Understanding the animal's importance and the source of the person's attachment to the animal is essential. As an illustration, dogs are assuming a growing range of roles in relationships with people. In a classic study, James Serpell (1983) showed that dogs are perfectly matched with their owners' expectations of the "perfect dog", in that they all excel in the essential traits of welcoming behavior, attentiveness, loyalty and affection, expressiveness, and enjoyment of walks. The beauty of cats and their behavior entrances many people, and with early socialization to people, cats often exhibit affection and interactions with people in a similar way to dogs, which people tend to value. For many people, their animals' perfection in certain aspects far outweighs the significance of behavior problems such as barking, housesoiling, or even aggression.

In a psychoanalytic sense, the relationship with an animal can help a person in continuing to develop their own self-concept. Much like a loving mother, a companion animal can reflect back positively to a person, and be somewhat compensatory for human companionship that may be lacking. In a study of the self psychology role of animals, Sue-Ellen Brown (2004) explored how animals served as selfobjects to provide self-cohesion, self esteem, calmness, soothing, and acceptance to people. Animals served as self objects in mirroring, idealization, and twinship for people.

Individuality of relationships

While some qualities of relationships with companion animals seem universal, at the same time, each relationship is unique. As with any human relationship, the person is an individual with a unique personal, family, and cultural history with animals. The animal has its own breed characteristics and individual mannerisms and personality. The pair live in a certain setting, with certain habits of husbandry and contexts for interacting. Over time they establish a unique relationship with its own routines and rituals that are familiar to both parties, and also to some other people and animals. It is a one-of-a-kind relationship that evolves and is shaped over years, growing with time and being based on the specific experiences of the pair.

Dogs and cats

A variety of psychological instruments are available to assess a person's attachment to a companion animal. As noted by Lee Zasloff (1996), most of these favor dogs by including questions about walking or traveling with the animal. She designed an instrument focusing on the comfort offered by the animal, Comfort from Companion Animals Scale, one that gives equal opportunity to dogs and cats. Beneficial effects of companion animals have been reported with both dogs and cats.

Animals' place in the family

At a cultural level, we see that pets are now considered to be part of the family. Grieving the death of an animal is accepted. Veterinarians and their staffs in the past couple decades have quickly incorporated these societal changes into their practices, often featuring or referring clients to puppy classes, behavior problem treatment, pet loss counseling, and at-home euthanasias. Some practitioners have assumed a niche practice to serve only cats, to treat a large proportion of patients that are working dogs, or to assist in community animal-assisted therapy programs.

Many studies have documented the psychosocial benefits that can be associated with being with companion animals (Hart, 2006). Protection from depression and loneliness, social facilitation, motivation to be involved and active, and cardiovascular benefits have been reported in numerous studies. Families especially value companion animals to provide experiences for their children (Melson, Schwarz, and Beck, 1997). The animals provide opportunities for experiencing nurturing and are listed among the children's friends.

In listing expectations from their veterinary staff, clients above all seek respect for themselves (Case, 1988). Other priorities relate to the way the clients are treated, how they are informed about the pet's behavior and whether the veterinarian listens to their concerns. Another classic paper (Catanzaro,1988) showed that veterinarians underestimated the importance of the animal to the client; it seems likely that data would differ if this study were repeated today.

The growing importance of animals is experienced daily in veterinary hospitals where staffs witness the distress brought about by a new behavior problem in the home, such as house soiling or aggression. Assisting families in avoiding these problems or correcting them in the early stages assures appreciation and loyalty from clients. The growing popularity of adoptions from shelters, where a history of behavior problems is more likely, makes it even more essential to offer proactive assistance in early intervention for behavior problems.

The significance of animals in people's lives does not simplify veterinary practice. The heightened importance of the animal can lead to serious challenges in dealing with clients, as highlighted by the AVMA Committee on the Human-Animal Bond (1995), who detailed specific strategies for dealing with clients who are difficult, disturbed, or violent. The broadening roles of specialized assistance dogs require appropriate accommodation in veterinary care. Persons who are extremely attached to their animals and also emotionally or psychologically precarious can pose special challenges when the animal has health problems.

Limited access to companion animals

Many people who would like to benefit from contact with companion animals lack access to ongoing or sporadic contact with them, especially the elderly. As people downscale their homes to small apartments, they experience more limits on keeping animals. They also may have physical limitations that make it difficult to care for an animal. Community programs to offer contact with animals, or volunteers to assist in aspects of pet care, could be developed more widely to offer greater access to companion animals. Pets Are Wonderful Support (PAWS) in San Francisco serves as a model for providing these types of services (Gorczyca, Fine, Spain, Callaghan, Nelson, Popejoy, Wong, and Wong, 2006).

Organizational support

Veterinary activities that pertain directly to the enhanced relationship with the animal are consolidating into the concept of "veterinary family practice", or community family practice, a group that meets during AVMA and considers how to formalize some of these changes that have occurred in veterinary medicine. The Association of Human-Animal Bond Veterinarians and the American Veterinary Society for Animal Behavior are well-established organizations for gathering and disseminating new information while also networking with others who have similar interests. The International Society for Animal-Assisted Therapy is formalizing instruction for health professionals who seek knowledge for applying animal-assisted activities and therapy within their work.

Conclusions

The importance of companion animals continues to grow, against a background of increasing societal and economic complexity in veterinary practice. Building on families' attachment to their animals, seeking meaningful connections with clients and their animals, over time, remains a rewarding and effective aspect of providing veterinary care.

References

AVMA Committee on the Human-Animal Bond. 1995. AVMA guidelines for responding to clients with special needs. Journal of the American Veterinary Medical Association 206, 961-976.

Brown, S.-E. 2004. The human-animal bond and self psychology: Toward a new understanding. Society & Animals, 12:67-86.

Case, D. B. 1988. Survey of expectations among clients of three small animal clinics. Journal of the American Veterinary Medical Association 192, 498-502.

Catanzaro, T. E. 1988. A survey on the question of how well veterinarians are prepared to predict their client's human-animal bond. Journal of the American Veterinary Medical Association 192, 1707-1711.

Gorczyca, K., Fine, A. H., Spain, C. V., Callaghan, D., Nelson, L., Popejoy, L., Wong, B., and Wong, S. 2006. History, development, and theory of human-animal support services for people with AIDS/HIV and other disabling chronic conditions. In: Handbook on Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice, 2nd ed. (A. Fine, ed.), pp. 303-354. Amsterdam: Elsevier.

Hart, B. L., Hart, L. A., and Bain, M. J. 2006. Canine and Feline Behavior Therapy, 2nd ed. Ames, Iowa: Blackwell Publishing.

Hart, L. A. 2006. Community context and psychosocial benefits of animal companionship. In: Handbook on Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice, 2nd ed. (A. Fine, ed.), pp. 73-94. Amsterdam: Elsevier.

Hospice Association of America. 2009. Hospice patients' bill of rights. Website accessed February 5, 2009: http://www.nahc.org/haa/attachments/BillOfRights.pdf

Lattanzi-Licht, M. 2001. Hospice as a model for caregiving. Hospice Foundation of America. Website accessed February 5, 2009: http://www.hospicefoundation.org/teleconference/2001/model.asp

Melson, G. F., Schwarz, R. L., and Beck, A. M. 1997. Importance of companion animals in children's lives—Implications for veterinary practice. Journal of the American Veterinary Medical Association 211, 1512-1518.

Remen, R.N. 1996. Kitchen Table Wisdom: Stories That Heal. New York: Riverhead Books.

Remen, R.N. 2000. My Grandfather's Blessings: Stories of Strength, Refuge, and Belonging. New York: Riverhead Books.

Serpell, J. 1983. The personality of the dog and its influence on the pet-owner bond. New Perspectives on Our Lives with Companion Animals. Philadelphia, PA: University of Pennsylviania Press, pp. 57-63.

Zasloff, R. L. 1996. Measuring attachment to companion animals: A dog is not a cat is not a bird. Applied Animal Behaviour Science 47, 43-48.