Caregiver Support

When treating a cat with chronic pain, it is important to consider the caregiver’s four budgets of care – emotional, physical, time, and financial. Be flexible when offering treatment options and developing treatment plans in order to accommodate the caregiver rather than developing a rigid plan based on a so-called ‘gold standard,’ which a caregiver may not be able to follow or implement.

• Emotional Budget, which may be impacted by:
• Other burdens in caregiver’s life (e.g., sick child/parent, own health issues, etc.)
• Personal mental, physical, and cognitive wellbeing
• Attachment to cat
• Physical Budget
• Physical limitations (e.g., senior caregiver with severely arthritic hands may not be able to administer insulin)
• Ability to administer medication
• Budget of Available Time
• Employment schedule may restrict ability to administer q8h medications or even q24h consistently
• Employment or travel schedule may restrict ability to monitor the cat. Home video cameras that can be accessed remotely may be useful in some cases
• Other responsibilities at home may have an impact on available time to manage the cat’s care
• Financial Budget
• Consider the ongoing care needs and the caregiver’s financial budget to meet those needs

      Reprinted with permission from the AAFP. Ray M, et al. 2021 AAFP Senior Care Guidelines Journal of Feline Medicine and Surgery. Available at catvets.com/senior-care.

Client Communication

Discuss each budget with the caregiver to find out what works best for the cat, caregiver, and/or the family in order to provide the best care for the cat.

• It is important to have a discussion with the caregiver and be cognizant of what they can realistically do at home.
• In order to keep the bond between cat and caregiver, avoid prescribing without understanding if administering the medication(s) is achievable by the caregiver
• Consider if the cat will/does experience caregiver aversion associated with administering treatments or therapy
• Consider what the caregiver can actually manage. Revisit this over time – caring for a cat in long-term pain is a commitment and many caregivers may start off able to implement the treatment plans, but their budgets of care may start to change. It’s important not to make them feel bad or guilty for not being able to fulfill the treatment plan – have an open and honest conversation about what is best for their cat and possibly for the caregiver. Do not underestimate caregiver fatigue
• In order to effectively support caregivers, follow-up and outreach is very important. The practice team should be monitoring treatment and compliance, and mentoring and providing support to caregivers.
• Identify someone in the practice to be the primary contact who will be the champion for caregiver outreach since it is a lifelong pain protocol and it will evolve with the cat’s disease, the cat’s age, and the cat’s changing needs. Identify one back-up at the practice to help as needed. Identifying one person helps keep the communication going in order to support the cat, support the caregiver, enhance the cat-caregiver bond, and build trust with the veterinary practice
• Develop a process to send and receive communications from caregivers. Incorporate notes and discussions into the patient’s records. Include cataloging images of the cat over time and/or videos (i.e., for mobility)
• Provide links to valuable easy-to-use/read information that can be referred to as needed
• Compliance really does make a difference in the lives of these cats. Caregivers are part of this process and they need our support.
• It is critically important that the practice identify which pain scoring tool they will all use for each particular patient in order to help track pain and detect early changes early.
• It’s important to note that pain doesn’t just fluctuate with age, but those in chronic pain may have day-to-day changes which include other factors in the cat’s life such as other illnesses, environmental stressors, caregiver budgets, etc.
• Ensure time is provided to converse with the caregiver about their needs and how they are managing their own budgets of care.

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