Pet euthanasia in the modern era is more of an experience than a medical act.  For the veterinary team, it’s an artful blend of empathy, time management, medical procedure, and connecting with those present. For our clients heavily bonded with their pet(s), feeling safe and supported is paramount right from the start.  This connection or rapport made with both the humans and pets sets the tone for the whole experience.  Many times, the success of the euthanasia is not only measured in how peacefully the pet died, but how cherished and loved everyone felt in the room.

Establishing rapport, aka bonding with everyone who’s attending the euthanasia is easy for some and hard for others.  It’s nice that it doesn’t have to be complicated.  A gentle smile, eye contact, getting to know the pet, and setting a compassionate tone is plenty for many of us.  What’s important is to start off on the right foot.  When we begin with the idea of building rapport in mind, there is no reason to back track if things have gone awry. 

While there is much more to building rapport with clients and your patient, here are some basic tips anyone can do when the appointment begins (assuming a non-emergency setting):

1. Take time to learn everyone’s names
2. Allow the pet to get comfortable in the space, then spend a few seconds focused only on them.  Praise and thank them for this life well-lived.
3. Sit at the same level or lower than the client
4. Be friendly, yet respectful to the tone of the procedure
5. Slow down and settle in to the room.  The client should feel they have your undivided attention.

Regardless of your comfort level, there are some simple communication skills we can strive for. From a Psychology Today article from 2015, titled How to Build Rapport: A powerful technique, they list the following:

• Match and mirror behavior – this includes sitting when others are sitting, lean forward then they do, or matching up with another’s breathing rhythm.  One of my favorite mirror behaviors is to take a deep sigh at least 1 or 2 times during the euthanasia appointment.  When I sigh, my clients almost always sigh right after, and if not, there is still a subtle relaxing energy shift in the room. And remember, it’s always ok to cry with clients.

• Find a common energy level – you are looking for harmony between your bodies and mental states.  If the client is sad, the veterinary team is somber.  If the client is joyfully reflective on the pet’s life, the team can be cheerful with them.  What we don’t do is mirror negative energy, such as anger or hostility. Instead we diffuse it by remaining calm and composed, with the hope our clients will mirror us.

• Maintain a supportive tone of voice – safety and trust in the veterinary team may go out the window if our tone gets shrill, angry, or high-pitched.  Even if the euthanasia procedure is getting complicated, and our adrenaline is kicking in, the tone of voice we project has to remain placid.  A supportive tone is soft and balanced will convey disciplined authority, leaving our clients feeling safer. 

In Dr. Jane Shaw’s End-of-Life Communication Module, part of the IAAHPC’s Certification Program for Animal Hospice and Palliative Care, she highlights the importance of asking open-ended questions when establishing rapport; to help people open up and share their thoughts / feelings.   “What do you know about the euthanasia procedure?”,  “What have you and your family discussed in preparation for today?”, and “How would you like me to help with her aftercare?”.  These open-ended questions empower clients to feel more in control.  They feel heard and are more likely to believe in the veterinary team’s abilities.  Dr. Shaw also talks about offering partnership to clients.  Statements like “We are all here together to support Ollie in this transition”  and “Let’s gather around to create a circle of love.”  The notion of losing a beloved pet can feel very isolating.  Building a sincere relationship with clients, and everyone in the room, is like a warm hug to sustain them during such a sad time.

Sometimes we don’t find the rapport we are looking for.  Clients have the right to be gripped by their grief and ignore normal ‘non-grief’ social behavior.  They can be angry, overwhelmed, confused, and lost.  Building rapport may be the last thing on their minds.  Those of us facilitating the euthanasia will never-the-less remain kind and open to their needs; offering gentle smiles and space to grieve. Dr. Alan Wolfelt, a widely respected grief expert, told me years ago, “When you don’t know what to say, don’t say anything at all.  Mouth closed, ears open, and presence available.”  Brilliant.