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Quality of Life Scale (The HHHHHMM Scale)
Score the pet on each item below using a scale of 0 to 10 (10 being healthy).
See the above caveats when interpreting the result.
HURT - Adequate pain control & breathing ability is of top concern. Trouble breathing outweighs all concerns. Is the pet's pain well managed? Can the pet breathe properly? Is oxygen supplementation necessary?
HUNGER - Is the pet eating enough? Does hand feeding help?
HYDRATION - Is the pet dehydrated? For patients not drinking enough water, subcutaneous fluids daily or can supplement fluid intake.
HYGIENE - The pet should be brushed and cleaned, particularly after eliminations. Avoid pressure sores with soft bedding and keep all wounds clean.
HAPPINESS - Does the pet express joy and interest? Is the pet responsive to family, toys, etc.? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed be moved to be close to family activities?
MOBILITY - Can the pet get up without assistance? Does the pet need human or mechanical help? Does the pet feel like going for a walk? Is the pet having seizures or stumbling?
MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware that the end is near. The decision for euthanasia needs to be made if the pet is suffering. If death comes peacefully and painlessly at home, that is okay.
*TOTAL SCORE (0 - 70)* A total over 35 points represents acceptable life quality to continue with pet hospice.
Original concept, Oncology Outlook, by Dr. Alice Villalobos, Quality of Life Scale Helps Make Final Call, VPN, 09/2004; Canine and Feline Geriatric Oncology: Honoring the Human-Animal Bond, Blackwell Publishing, 2007. Revised for the International Veterinary Association of Pain Management (IVAPM) 2011 Palliative Care and Hospice Guidelines.
Available for download at www.pawspice.com.