Editorial: Man’s Best Friend
As home healthcare providers, I know you have encountered many pets in the homes you visit. Even for those who are fond of animals, these loyal “friends” can be a nuisance for home care clinicians. I myself was bitten by a dog who had recently given birth to a litter of puppies. The patient’s husband greeted me at the door and ordered the dogs back (there were several). My first mistake was not asking him to secure the dogs in another room. The problem was, he was frail and overwhelmed with the care of his wife who had advanced dementia, and it was their daughter, with mental health issues who kept bringing the strays home. I didn’t feel I could burden him with another expectation. We had notified Adult Protective Services several times, but he just wouldn’t, or couldn’t, keep his daughter from bringing stray dogs home. After I started the visit I phoned the physician, who requested lab work. Out to my car I went, not even thinking about the dogs. Shortly after I re-entered the home, the dog who had given birth, protective of her litter, lunged at me. I ended up in the emergency room with seven stiches to close a gash on my leg. Sadly, the agency decided they could no longer provide services to this patient unless all dogs were removed from the home – a goal that was never achieved.
As harrowing as that event was, my favorite animal story happened to a friend. While she was making an opening visit, she kept hearing a loud racket coming from the upstairs of the home. She finally asked the patient what was going on up there. His reply caused a surge of stress hormones and a hasty retreat from the house. “I told him not to bring them dang snakes into the house. Now they all went and got loose and they’re poisonous.” My friend quickly administered his dose of heparin and exited the home. She wrote “unable to complete visit, poisonous snakes loose in home” as she hurried to her car. I don’t know if care every resumed in that home, but my guess is, it would have been difficult to find someone willing to make another visit.
Even when the pet is small and friendly, they pose a risk to visitors. An appliance delivery person recently told me he tripped over a small dog who got underfoot as he was delivering an oven. The oven fell to the ground, breaking a tile in the floor and denting the oven.
Authors Susan Lombardo and Kendra Schmitz wrote an article for this issue on this very topic. While they recognize the health and social benefits of pet ownership, they promote the implementation of a pet policy agreement to be completed at the start of care. With this agreement, the patient or caregivers would be made aware that all pets must be secured in another room or outdoors during the visit. This policy is meant to protect the patient as well as the clinician, as pets can make infection control more difficult in the home. Consistency is key to the success of a pet policy. Every employee who makes home visits would need to understand that this is an agency policy. Once one person doesn’t adhere to it, the patient will expect the same in subsequent visits. I urge you to bring this article to your next staff meeting for discussion. If your agency already has a pet policy, discuss how consistently it is enforced.
Do you have a home care pet story to share? Email me at HHNEditor@gmail.com. We would love to hear about it.