Pet parent information Pet Parent Name Pet name Email address Date Note Please note that a 10 would indicate normal prime of life condition. Zero would represent the worst condition possible. Quality of Life Scale: The HHHHHMM Scale HURT - Select -12345678910 Adequate pain control, including breathing ability, is of top concern. Trouble breathing outweighs all concerns. Is the pet's pain successfully managed? Can the pet breathe properly? Is oxygen supplementation necessary? HUNGER - Select -12345678910 Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube? HYDRATION - Select -12345678910 Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake. HYGIENE - Select -12345678910 The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean. HAPPINESS - Select -12345678910 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? MOBILITY - Select -12345678910 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.) MORE GOOD DAYS THAN BAD - Select -12345678910 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 for euthanasia needs to be made if the pet is suffering. If death comes peacefully and painlessly at home, that is okay. Pet caregivers can use this Quality of Life Scale to determine the success of pawspice care. Score patients using a scale of 1 to 10.
