Wednesday, November 11, 2009
This Quality of Life Scale got me thinking it would be a good way to keep track of Merlin's state. DM is insidious- it slowly advances and it can be hard to know when the end is coming. I thought if I used this scale every few months or so, I'd see when his quality of life decreases.
So here we are in November, 2009.
H: 0 - 10 HURT - Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet's pain successfully managed? Is oxygen necessary?
I'd give Merlin an 7 here. I don't think he IS in pain but I don't know for sure. He can certainly breathe but he does whine a lot and I don't always know whether he wants something or if something else is going on.
H: 0 - 10 HUNGER - Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
8 here. He IS hungry because of his medications. He eats well and has no problems, but he is hungry, which isn't a great thing.
H: 0 - 10 HYDRATION - Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
A 10. A 10 plus; he is, if anything, too hydrated!
H: 0 - 10 HYGIENE - The patient should be brushed and cleaned, particularly after elmination. Avoid pressure scores and keep all wounds clean.
I'd say a 7 here. It's harder to keep him clean and dry as he won't or can't go outside when he needs to. He's had more baths in the last three months than the rest of his life put together.
HAPPINESS - Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed be close to the family activities and not be isolated?
This is a hard one to answer. He's not responsive to toys but hasn't been in a long time. He loves me, has never been responsive to the other dogs or other people. He likes to go for walks. But he IS anxious and bored or lonely or both, and he won't stay close to me if I'm in the bedroom. So I'd give him a 6.
MOBILITY - Can the patient get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)
He's pretty mobile in his cart and out of it. Another 8.
MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
Definitely more good days as he has only had a couple of bad days when he wouldn't eat and didn't want to walk. 8
So that gives him a 54. A score of 35 or higher says your "Pawspice" is successful.