What do pet caregivers need?

Introducing new research into veterinary palliative and hospice care

Being the caregiver of a companion animal can have huge benefits. They bring joy, companionship, understanding and unconditional love to a person’s or a family’s life. Much has been written about the Pet Effect - the positive effect of “pet ownership” or living in mixed-species families (Ashall et al., 2024).

But how does the Pet Effect change when these same bundles of joy and love get ill and eventually die? What happens to caregivers’ health, both mentally and physically, when their best friend starts needing more intensive care? The literature shows that caregivers of ageing and chronically or terminally ill companion animals report symptoms of increased caregiver burden, depression, anxiety and guilt. The financial stress that often comes with palliative and hospice care weighs heavily, too. (Zoanetti et al., 2024)

Man and his dog. Photo by gaspar zaldo on Unsplash

The hundreds of decisions that define palliative care

In my years of working as a veterinary nurse, end-of-life doula and founder of the Autumn Animals clinic, I found that families often feel lonely and not well supported by their community in this journey. Many felt like their GP vet could have given more support or communicated the options better. Some just didn’t have the resources - financial or otherwise - to continue with the intensive care a companion animal sometimes needs towards the end of their life. And others wondered about the ethics and moral implications of euthanising the person they vowed to care for until the end, rather than letting them die naturally.

Diseases often creep in with ageing pets. You can see it with the “stubborn dog” with the collar pulling over his neck, because he just wants to sniff every tree. Or the kitty who doesn’t groom herself as meticulously anymore and drinks a bit more water than before. We often hear “they are just getting old”. As long as these pets don’t come down with an acute manifestation of a disease, the veterinarian usually only sees them once yearly. By the time a disease gets diagnosed, the symptoms are often so bad, making it more difficult to get back from. In hindsight, caregivers see the behaviours they spotted ages ago that were actually symptoms of disease - and feel guilty or even foolish for putting it down to the dog being stubborn, or the cat being lazy.

Palliative, and eventually hospice, care for our companions means making hundreds of small yet impactful decisions each day. These decisions can have major impacts on the quality of life for both human and non-human animals.

Do I feed them the kidney diet the vet prescribed, even though it’s not palatable and they would rather refuse to eat at all? Or do we feed them the meaty food they enjoy so much, knowing that it might speed up the demise of the kidneys?

Do we go on our yearly, much-needed holiday, leaving the dog with a sitter, or do we stay home, knowing that going away will only make him more confused, being in a strange environment?

Do I need to continue treating side effect B from the medication that treats disease A, because I fear stepping off the treatment train would be seen (and judged) as “giving up”?

Does letting go of my pet mean the end of my identity as a pet owner due to my age?

How does euthanising my best friend, the person I said I was going to take care of until the end, square with my ethical beliefs?

How did my line in the sand keep on moving further away?

Many of these questions can cause ethical challenges for both the caregiver and veterinarian, especially when caregivers continue to choose futile treatment. Not to mention negatively impacting the quality of life of the patient. 

Why it takes more than a veterinary team

It is my belief that people shouldn’t be facing these questions and situations alone or with the bare minimum support from a veterinary team. Yes, veterinary teams can be amazing sources of support, care and information. But we also know that many practices are busy and understaffed. Just like raising a child takes a village, caring for an older or ill person (human or non-human) takes a community, too. We don’t want to leave it up to Google or AI to coach caregivers or give advice on such tender issues.

I am arguing for an interdisciplinary approach to care for caregivers and companion animals that doesn’t put all the pressure on the veterinary team. I am arguing for opening up the silo and learning from our colleagues in human healthcare.

Human palliative care can be described as 'the interdisciplinary pursuit of quality of life' (Miller, 2021) and is available to anyone suffering from a temporary or chronic ailment. Hospice care follows once treatments are considered futile, to keep the terminal patient physically, emotionally and spiritually comfortable. In countries such as the USA and Canada, care is distributed among the veterinary team, whereas in the UK, veterinary palliative and hospice care is the domain of the veterinary surgeon. I experienced that when I started Autumn Animals as an interdisciplinary care organisation, building on the Dutch Buurtzorg model, a nurse-led community care organisation for older people. I wanted veterinary nurses to support families and suggest or prescribe interdisciplinary care, whether that was physiotherapy or acupuncture for the dog, or bereavement support for the human. Legally, this proved infeasible, and the referring veterinarians found it confusing. Autumn Animals only started getting more traction when I hired veterinarians and started offering home euthanasia. 

The few families we did manage to support earlier in their journey - the autumn phase - with interdisciplinary care reported fantastic results of improved quality of life and bonus time with their pet, who seemed to perk up with the interventions. But perhaps more poignant is that the people’s grief, both anticipatory and post-death, felt supported, acknowledged, and less complex. 

It showed that proactive, interdisciplinary care helped make the end-of-life experience better for both humans and companion animals.

The care that we provided with the mobile Autumn Animals clinic has given me lots of anecdotal evidence that this kind of support is what is needed in veterinary care. However, my ideas were mostly based on what Í felt was needed. The website literally stated: “Sieske [...] set up the kind of hospice care company she would like to use by the time she would need it for her cat, Lewis.” And yes, I was able to give Lewis the best care possible because I knew what to do and where to look this past year. 

Introducing the research: what do pet caregivers actually need?

Now I’m interested in hearing what other people need and taking a more bottom-up approach. The research is so limited as to what caregivers actually need (Mouro, 2025) that I have proposed (and secured funding through the IAAHPC for) a research project which explores exactly that: What is it that caregivers need? Rather than offering them a smörgåsbord of what I think they need, I will ask them first. 

Following this first project, I will then return to the drawing board, together with these caregivers and a handful of pet and vet professionals, to actually design a toolkit with interventions that will support caregivers through their pet’s autumn and winter and what comes after.

I am super excited to get started with it because not only do I get to put my social researcher hat back on, but I also get to listen to people who will share their pets’ stories with me and collaborate with them to create something that will make a difference in the lives of our older pets and the people who care for them.

If you’re interested in coming along for the journey, sign up for my monthly newsletter and connect with me on LinkedIn and Instagram. 

For now, I’ll leave you with this question: What one act of care did you receive at a challenging time in your life that you’d wish anybody would have access to when they are navigating palliative or hospice care for a loved one? Please share yours in the comments below.

Sies.

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About me

My name is Sieske Valk (pronounced as Sees-kuh Falk). Most people call me Sies. I started my career as a veterinary nurse in the Netherlands. Following a short stint as a social science researcher in climate change adaptation, I set up an animal home-care company in London called Sies Petcare. This grew into Autumn Animals, the UK’s first holistic palliative and hospice care organisation. Trained as an end-of-life doula for companion animals, I supported numerous families through the autumn and winter of their companion animal’s life and what comes after. 

I currently focus on three pillars within ageing pet care under the brand Autumn Animals:

Coaching pet caregivers with ageing pets, writing about caring for ageing companion animals and research about interdisciplinary palliative care for companion animals.

If you’d like to know more about Autumn Animals, visit autumnanimals.com.

I live on a farm with my husband, Jamie, in beautiful Devon, and have a Lewis-shaped hole in my heart.

A note on AI use: All the articles on this website are written by me. The flowery and long sentences are completely my own. I use Grammarly to correct spelling, grammar and the occasional Dunglish. Claude Cowork helps me plan content and create visuals.