Peace of Mind for Pet Parents Episode 083: PEACEFUL at 10: The Story Behind the Quality of Dying Guide
Welcome to Peace of Mind for Pet Parents!
What does it mean to understand dying rather than simply fear it?
Ten years after creating the PEACEFUL Quality of Dying Guide, Gail Pope reunites with co-creators Kathryn Marocchino, PhD and Ella Bittel,DVM to share its story. Together with Karen Wylie, they explore natural dying, quality of life, caregiver choice, and why education, relationship, and loving presence remain at the heart of animal hospice.
Ten years ago, Gail Pope, Dr. Ella Bittel, and Dr. Kathryn Marocchino brought their experience and perspectives together to create the PEACEFUL Quality of Dying Guide: Signs of a Peaceful Passing—a resource designed to help caregivers recognize and better understand what may occur as an animal approaches natural death.
For its tenth anniversary, Karen brings the three co-creators together again to remember how they found one another, why they believed this resource was needed, and what they have learned along the way.
Their conversation moves from the origins of animal hospice and hospice-supported natural death to quality-of-life monitoring, caregiver choice, adaptability, education, and the profound role of presence and relationship during end of life.
And as they look back, the conversation also looks forward—to new ways of helping caregivers understand their role, build a supportive circle of care, and accompany the animals they love through the whole journey.
Additional Resources:
PEACEFUL: The Quality of Dying Guide Signs PDF
Disclaimer: As always, remember that our insights come from decades of caregiving experience. For any medical questions, your veterinarian is the best resource.
About the Hosts
Together, Gail and Karen bring decades of experience in animal hospice, education, and caregiver support, guiding families along the bright path.
Karen Wylie, EdD is Executive Director of Animal Hospice Group and Co-Founder of BrightHaven Caregiver Academy. With decades of hands-on experience caring for cats, dogs, and horses through chronic illness, palliative care, and natural death, Karen brings both professional expertise and deep personal wisdom to every conversation. She is passionate about preparing pet parents for the full journey — not just the diagnosis, but every stage that follows.
[Learn more about Karen →]
Gail Pope is the Founder of BrightHaven and a pioneering voice in animal hospice and natural death care, author of The BrightHaven Way: Lessons from 700 Animal Teachers. For over thirty years, Gail has provided sanctuary, hospice, and holistic care to hundreds of animals, bearing witness to countless peaceful natural passings. Her work has inspired pet parents and veterinary professionals around the world to see death not as a failure, but as a sacred and natural part of life.
[Learn more about Gail →]
RESOURCES MENTIONED & RELATED LISTENING
Menu for Healing PDF - Free download
PEACEFUL PDF - Free Download
LIVING Quality of Life Care Assessment Tool — Free download
BrightHaven Animals YouTube Channel — Search: BrightHaven Animals | @brighthaven_animals
Animal Hospice Group (animalhospicegroup.com) — professional certification organization in animal hospice and palliative care
You might also find helpful:
Episode 077: 3 Caregiver Myths — Your Heart Knows What It’s Doing Too
Episode 076: Is Dying Painful? Your Pet’s Body Knows What It’s Doing
Episode 073: Reading What They Can’t Say: Pain, Comfort, and the End-of-Life Journal
Episode 023: Living to the Last Breath: A Pet Parent’s Perspective on Dying Naturally
Episode 069: Preparing for Your Pet's Death — Physical, Emotional, and Spiritual Ways to Make Every Moment Count
Episode 058: Can My Pet Die Peacefully at Home? What Natural Death Really Looks Like
Related reading:
- The Other Doctor in the Room: Trusting Nature at the End of Life
- Walking the BrightPath: A Pet Parent’s Guide to Home Hospice and Natural Transition
- Emotional Support for Pet Owners Facing a Difficult Diagnosis: Coping with Guilt, Fear, and Grief
- Monitoring Your Pet's Health at Home: A Palliative Care Guide for Chronic and Difficult Conditions
Episode Transcript:
Karen Wylie: Hello and welcome to Peace of Mind for Pet Parents. I'm Karen Wylie. Here, as always, with my wonderful friend Gail Pope but you may notice we have a couple other faces on screen and friends with us for a special conversation today. With us are Dr. Kathryn Marocchino who you may know as a co-founder of Animal Hospice Group since some of our listeners are AHG students, current or past. Also, Dr. Ella Bittel, who is a veterinarian in Costa Rica at this point, Ella?
Ella Bittel, DVM: Correct. Greetings from the jungle.
Karen Wylie: We're so glad to have you both with us. So the reason that these two lovely ladies are with us today is because, I guess it was last month, I was pulling out the "Peaceful: Guide to a Peaceful Passing", and some of you get that on our BCA website and are able to download it there. I was sending a copy out to a client and I noticed that the copyright said 2016.
Given that it's 2026 now, I realized that we were probably looking at a document that had been created with a lot of love and intention 10 years ago by Gail, Ella, and Kathryn. So I asked if they would be willing to get together and have a conversation about getting together to support their interest in animal hospice and what they felt caregivers needed.
So that is the focus of our conversation today. So I'm going to get my executive producer off of my paperwork. First of all, how did the three of you find each other? How did you become colleagues and friends?
Gail Pope: Do you want the long version? Or the short version? I can give you a short version. Hold on. There's a lot of history that goes before, but I was sitting at my desk at the BrightHaven Sanctuary one day bearing in mind that BrightHaven had been in existence then for 40 years at least, and I was very comfortable with the work that I did.
So the phone rang and I picked it up and a voice said, "Oh, hello. Can I speak to Gail Pope?" And I said, "Yes, this is Gail." And she said, "My name's Dr. Ella Bittel, and I'd like to talk to you about animal hospice care." And there she was really excited, "Here we are, kindred spirits!" And I said, " What? I'm sorry. I think you've got it wrong. BrightHaven is all about living, and hospice is about dying. We're all about our animals living well through their whole lives."
So I think that gave her a bit of a shock, so we got into conversation and that's when I realized that the work that I'd been doing for all those years actually could have been labeled hospice. But I grew up in a culture where death was a bad word and dying was scary. It's a really scary thing, and people just stayed away from it, and I'd done the same. But what I'd learned in the early days of BrightHaven from hundreds of our animal teachers is that to them, living in the moment is what they do. They're not thinking about when they're going to die, and if living in the moment is with an illness, with lack of energy, it's still living. It's living as well as you can for today.
So that's probably the kind of conversation that Ella and I had that day. She told me about a new organization that was being formed. It was then through that conversation that I met Kathryn. So Ella, you can pick it up and take the baton and move it along to Kathryn.
Karen Wylie: What was the organization that was being formed?
Gail Pope: That was the International Association of Animal Hospice and Palliative Care, and Ella had been in conversation with Dr. Amir Shanan.
Karen Wylie: Okay.
Gail Pope: And she was just looking at, you know, who we should think of involving in this organization. She thought of me, and I thought she was an "idiot" at first.
Karen Wylie: Isn't it nice how first impressions can be shared now?
Ella Bittel, DVM: So I have a different version. I think that I met you way before Dr. Amir Shanan. It happened perhaps mostly through Kathryn. I'm very sure it was way before the forming of the IAHPC. The first memories I have are of the international symposiums for veterinary hospice that Kathryn put on. That's the version I'm sticking to.
Karen Wylie: Okay. All right, now, Kathryn, who's right? Who's right, Kathryn?
Gail Pope: I am.
Kathryn Marocchino, PhD: Chronologically, I had connected with Gail simply to pick her brain about who she was and what she did, and I think I was looking for advice way back when, but this was prior to the symposium. So I knew who she was and I knew what she did. Then we started planning the first international symposium on veterinary hospice care that was held at UC Davis. I remember being contacted by Ella cause we were trying to set up a slate of presenters. I can't quite remember if someone had mentioned you to me, Ella, but I know that they had told you.
You were aware that the symposium was going on and I know you'd reached out and asked if you could present. We said, yes, of course. What you were doing was absolutely fantabulous. That was how basically Ella came into the fold. Now, Gail was not able to attend that first symposium. If I remember correctly, she came to the second one. That was the one that she attended with Richard.
They got a standing ovation, and gave a wonderful presentation. But it was at that second symposium that Amir Shanan said to me that he was working on creating this new organization and he was going to make it happen. That didn't actually take flight, if you will, until the third international symposium. But he had started gathering people together so that he could actually form it and get it recognized as a 501[c][3]. Amir did not attend, actually, the third symposium, but he was very feverishly working on getting his organization the IAAHPC off the ground.
And of course, the rest is history. So that's a collection of it. But Ella, you gave such an incredible presentation at that first symposium. That was it, that sealed our friendship. It was absolutely impossible not to love Ella and what she did because she was just absolutely phenomenal. And what happened was we began realizing that we had the same ideas. We thought alike. We felt alike. So many conversations with Ella in which we would hug each other and she said, "I cannot believe that I've met you and that I've met Gail because this was all meant to be."
We obviously are completely on the same page. It still is very gratifying to be able to work with two people who get it, who sincerely get it.
Karen Wylie: I'm just thinking back to what the world was like in 2007 and 2008, and that's almost 20 years ago, and the internet was not the way it is now. It was obviously better than it was perhaps around the year 2000, but it still wasn't easy to find like-minded people. So I'm sure for the three of you it must have been just a really wonderful coming home in a way. To find people who understood your mind and heart and what you were working toward.
Ella Bittel, DVM: Very true.
Karen Wylie: So how did the three of you decide to create the "Peaceful Guide"? How did that all come about?
Gail Pope: Was that during the weekend that we all met up, didn't we? Did it come about before then or afterwards? I don't recall when we first really got the idea.
Kathryn Marocchino, PhD: You know, if I remember correctly, yes, we did. That was 2010. We'd started working on this. You know, we had been talking about it for quite some time. It was a very, very, very strong paradigm shift that needed to take place there. Most veterinarians, you know, came to the symposia with intentions of learning something, and many of them did and came away quite inspired. But there were others who were very reticent in embracing and accepting what we were doing because, let's face it, we were questioning the use of euthanasia in every single instance.
Ella Bittel, DVM: There is no other experience in these people that they can refer to.
Karen Wylie: I'm really glad to know that you're on the side of people who are open-minded and try to support the caregiver and their pet based on their situation, their condition of the pet, and their particular unique circumstances.
As any regular listener to our podcast would know, Gail and I both very enthusiastically support natural death as an option. And certainly for myself, I'll always say that's always my goal for my animal, to be able to decide on its own time when they're going to leave this planet. But I do also acknowledge that I don't know all the circumstances of other people, and so if they need to make a different decision, I can respect that. But I don't try to judge everybody based on the decisions they make or the work that they do. So I especially then applaud you for sticking with your perspective and what you feel is needed.
So that's when you were linking up with these two, who had also formed their own belief system of how they wanted to manage their own pets' illnesses and deaths. They found a similar spirit in you. So when you decided to work on the "Peaceful" document, the full name being "The Quality of Dying Guide: Signs of a Peaceful Passing", why was this particular tool for caregivers important to you to create?
Gail Pope: Oh my goodness, that could take us an hour, couldn't it? That part of the conversation.
Karen Wylie: Well, it's a very unique tool. There's nothing else like it out there.
Gail Pope: I think it really was, for me anyway, it originated from all the clients that I'd worked with because the most important thing that became obvious, I'm sure to all of us, was that what they needed to know, what they needed to understand was what is normal in the dying process.
Everybody else was saying what's not normal and let's euthanize, where we were saying, "Okay, this is normal. It's okay. This is what we can do if it needs anything to do." But these are the normal signs— human, animal, it doesn't matter. Two legs, four legs, it's the same process designed by Mother Nature. So it was just kinda obvious, what can we do? We can write articles, we can do things like that people will probably find boring, but we need something that will actually help people to actually understand. Don't you think? Can you add any more, Kathryn, Ella?
Kathryn Marocchino, PhD: We were thinking of actually putting our three organizations together, the Nikki Hospice Foundation for Pets, Spirits in Transition, and BrightHaven, in a consortium where the three of our organizations would be able to work together. I'm very gratified to see that what eventually happened with Animal Hospice Group was an extension of that idea. The important thing was that "Peaceful" became the culminating point, the epitome of our work, if you will.
I'm very gratified to see that with Animal Hospice Group, we've been able to continue that. This is one of the things that we use with pet parents. But from those various collaborative efforts of ours where the three of us would work together hours on end on the phone, on Zoom every time we could meet, as we did in Benicia in 2010, we would work on trying to define what is hospice-supported natural death and how can we make that become very clear to pet parents, hence the "Peaceful" document.
Ella Bittel, DVM: For me, the "Peaceful" list was a direct response to the quality-of-life scales out there. I really took some time to engage with them, to compare them. They have strong overlaps. Some go as far as scoring and using numbers to determine time to euthanize, which that in itself— wow.
I inevitably compare everything we do with animals that are sharing our lives with us as family members to what I would like with a human. Even just to say having more good days than bad days, to look at that I can only say please do not come to me when I'm on my deathbed and ask me "What? You're not playing tennis anymore?" I think it's time. The absurdity of it is two different planets that cannot meet. It is so stark. Still not embracing the mystery that is part of dying?
I understand where it comes from. I have all the compassion for it, all the compassion I swear. Veterinarians feel they are the ones that have to make sure that all goes well, right? It's their responsibility that all goes well. Now, they're entering a territory that no longer is accessible to complete control. You can try to plan, you can try to prepare but in the end, you do not know what you're going to encounter until you're encountering it.
Karen Wylie: Yes because if you can score something and come up with numbers for something, surely that decision is clear to everyone, what the right decision is to be made. As you may know, one of the first things Gail had mentioned to me that she wanted us to create was our own Quality of Life Scale and we did.
So the "Living Quality of Life Care Assessment" is intended to be a weekly quality of life tool. It's a monitoring tool, it's to monitor your pet's illness and what their condition is on a weekly basis. It's definitely not intended to be a quality of life tool that is administered the day of a euthanasia appointment to justify that the animal's ready for euthanasia, so it's "okay." I didn't use numbers, I used colors. Red, yellow, and green because I think for most of us when we're in the midst of end of life questions with our pets, the logical part of our brain is not functioning quite as well as the emotional side. Colors allow you to respond intuitively rather than trying to score what's happening with your pet.
So I'm with you on that. All of the quality of life scales out there do seem to somehow involve some numerical assessment. They're to be used at the very end of life to justify euthanasia when in fact quality of life is something we should all be looking at throughout our animal's life, not just in those last days.
Ella Bittel, DVM: And this is in accordance with how it is handled in human hospice. Human hospice also does evaluations of quality of life. And what are they for? They are to monitor if any adjustments in treatment are now advised. So it's never used to say, "This is it, my friends. We can't do any more."
Karen Wylie: You're right. This is all, "This is it."
Ella Bittel, DVM: It was one of the famous things that Eric Clough said, right? For me, he was like, "Dr. Eric Clough, the veterinarian , together with his wife, a human hospice nurse, Jane gave this..." He for me is like the initiator of animal hospice inside of the veterinary profession. He gave this first groundbreaking speech together with his wife in 1998.
And one of the things that I just loved him for saying was, "Don't ever say there is nothing more that can be done." It's like, "All right." I know Gail would have a different perspective on this but I have definitely seen situations where I was like, "This is not the time to try to not euthanize."
You know, we have to also be able to let go of our desire, to allow the animal to go in its own time at a moment's notice. What is so critical is this non-attachment to any idea is you go full-heartedly for what you are for and you accept it in the instant that you recognize this is no longer sustainable and change path. In that moment, you should have the power, you should have the ability to give something to the animal that will take its anxiety or take its pain or whatever it is in that moment. It doesn't have to kill but it takes away consciousness.
We're slipping into the area of palliative sedation which is hard to accomplish. I don't want to promote it as a general easy thing to do, but yes, it's a complex matter. It's a complex matter and requires adaptability at any moment.
Karen Wylie: Gail and I often talk about the fact that it often comes back to education because, generally speaking, preemptive euthanasia is the norm. That euthanasia— "better a day too early than a day too late."
Euthanize on a good day. A good day being when they're still playing and enjoying their Big Mac and their pup cup but at 3:00 they're going to be euthanized. So I think by that preemptive euthanasia norm that exists in veterinary medicine, they're losing out on understanding what decline actually looks like.
Ella Bittel, DVM: Yes.
Karen Wylie: And if you haven't actually lived with a pet month after month, week by week, then in the last days, you really don't understand what decline looks like. How you can support them along the way, what they need or what they don't need. A lot of times it's what they believe is needed isn't really what's needed. Our pets seem to know what they need. Many of them do seem to have a sense of certainty about what they believe is or is not.
For those of us who— I came to my first natural death because we were stranded here at the house in a major snowstorm and roads were closed. I couldn't get anywhere. And yet as scared as I was, there were so many positives to the death happening at home that upon reflection it was like, "Huh, that wasn't what I was expecting." But yet it was like, "Oh but that wasn't a good thing because euthanasia is the thing."
I know Gail had a similar kind of experience with her first natural death. That she was home. She didn't have a car. She couldn't leave the sanctuary and she had a cat dying. And so that was her first experience and I don't mean to speak for you, my dear.
Gail Pope: That's all right. Carry on. You're doing good.
Karen Wylie: But it's the kind of thing, like we were both pulled into this. I don't want to say we weren't willing. We didn't know what we were being pulled into but we weren't choosing it. We were not choosing it at that moment. But that allowed us to have a different experience of what a natural passing can be. That was totally different from our expectations.
Gail Pope: I'd love to go back a little bit, actually, to first of all ask Ella why she thought we might disagree about natural death. But that actually brought up for me one of the things that I do find, because people tend to think, "Oh, Gail's totally for natural death. We can't talk to her about euthanasia," and this kind of thing. But what comes up for me quite often, in fact, I spoke to a lady this last week. Even at the end of our conversation, I felt sad because she was so determined that her dog should be allowed to die naturally.
She was unable to do it. The dog actually was doing very well, however, emotionally she couldn't cope. She was completely— I mean, she lost her mind. She was in a terrible state and she really couldn't cope. And when you reach that kind of a situation where life becomes so overwhelming for you, the caregiver, and your ability or inability to be able to walk this journey with your animal then sometimes that choice for euthanasia has to be made.
Sometimes if you've got an elderly or an incapacitated person and they have an 80, 100 pound dog who's immobile, they can reach a point where they struggle against it. They don't want to euthanize. The dog isn't ready to die. We had several animals come to the sanctuary to live with us because their owner simply couldn't cope.
But again, in that situation, if there's no help available on a long-term or even a short-term basis around the clock, then a euthanasia decision is the kindest decision. So I think we need to balance that conversation a little bit by showing that we do understand there are times when and times when not.
And again, with a lot of the clients I have, I get really boring, I know. Sorry everybody out there but I advise anybody and everybody, there are so many wonderful books with stories about human hospice care. I still read them every night. I've probably read the book I'm reading now at least six times, and I've forgotten all the stories. So each time I read it, it brings them back again. These stories are so beautiful about the humans involved on the medical side and the animal side. They're full of heart. They're all about love.
They're not about medicine so much. Medicine's a big part of it for most of the hospice stories but they're all about love and relationship and caring for the caregiver and caring for the animal and caring for oneself if one is a medical person. It can be such a beautiful time of transition, and yet it can also be the opposite. Each time it's different.
Karen Wylie: Difficult for the caregiver who has not had education on what natural death looks like. Part of that is what happens in human illness and death, is that often we become so detached from what dying looks like and it's always handled by somebody else.
Gail Pope: Yes.
Karen Wylie: Not in our own homes and outsourced. I think that part of it, it carries over, right? It carries over to our lack of understanding of what's happening with our pets. We love them so much, we don't know what to do. When in fact, for the most part, we're not supposed to do anything but accompany them through their decline. But that's another episode topic perhaps for us.
I guess I'm wondering if we have time to just switch gears a little bit here to ask about where you guys currently see the field of animal hospice and where you would like it to go. Because obviously, 15 years ago, you guys were first getting together and meeting, and then you created "Peaceful" 10 years ago. Many caregivers have benefited from it. Certainly our AHG students have used it very successfully to provide support to their clients as their clients support their own pets.
So it's having the impact that you hoped for with many people. But what else needs to be done? What would you like to see happening? What changes would you like to see?
Gail Pope: Education, education. The more education— it sounds simple but we educate children in school about birth. Why don't we educate them about death and dying? And why don't we call it dying rather than death sometimes because it is a process. It is a transition. Transition in, transition out. I think perhaps for us, it is more about educating people so that they go to their veterinarians and ask the right questions. So that the medical community is going, "Oh, heck, I don't know. Maybe I need to learn about this." I think the more people ask for help, the more it will be seen as needed in vet schools.
Kathryn Marocchino, PhD: How do I feel personally? I'm coming to the end of my life, people. I was hoping to look back and be able to say, "I made this tremendous difference in the world." When I walked out of that first hospice symposium, I was on cloud nine. I remember telling Jerry Ryan, "I can die tonight and I would be so happy because I did what I wanted to do."
I saw people in the front row who were veterinarians. Don Klingborg, the medical director of that program, was in tears, listening to my presentation on Mickey. I heard a pin drop in that room when we all talked about what hospice was, and it was a very grand and glorious moment, and it meant something. We went somewhere. Something happened. Ella came up to me and said, "When I hear you speak, it's like a song because you really believe what you're saying." And that's the way it's been for all of us.
Karen Wylie: And as you guys know, although I provided hospice care and supported natural death for 35 years with my own animals, I'm new to the field of animal hospice. I've been executive director of Animal Hospice Group for three and a half years now. Gail and I have worked together just about that whole time.
So I have a more optimistic perspective than I hear from you guys. But I do still believe hospice is possible but I don't believe true hospice is possible if we continue to look at it within the veterinary system. I think we have to look at it through a different lens. Gail and I are calling that relationship-centered animal hospice because hospice really occurs at home. It occurs between the pet and the caregiver.
Now, that's not to say that we don't occasionally need a veterinary partner for testing that might need to be done and help. But really, hospice happens at home. So focusing on education for the pet owner, the pet parent, the caregiver, is where our attention is going. Many of our students at AHG are, in fact, pet care practitioners, and they're the ones feeling the pinch in terms of how to support their clients, whether they're a groomer or a canine massage therapist or a pet sitter.
They've got clients with senior dogs or ill animals, and they're trying to support those clients through the end of life. We have grief counselors, animal chaplains, energy practitioners. We have the true spectrum of wholistic practitioners that are trying to provide support for body, mind, spirit, and relationship to their clients. And that's not all about medicine.
So for me, my way of finding a path through the darkness is literally to find a new path that brings in veterinary partners who want to support a pet owner in providing an end of life for their pet that is possible.
Gail Pope: Hear, hear, Karen. That just is so perfect because I was sitting here thinking how much I love the work that I do. How heartwarming, how beautiful it is to have what we call a consultation that actually isn't really— I guess it is a consultation at some level, but for me it's a heart-to-heart exchange with someone who loves an animal deeply and wants to do their best for them. They're looking for that help.
They understand that they have a choice when the end of life comes, but they're in a situation right now where it's all about love. It's all about how can I best help? And that's where I can help. So to be able to help one person to tread that path and in doing so find other people that can help them if necessary too. That's the icing on the cake.
And yes, I think we've got an awful long way to go but I still think there's hope. I've said it over and over again and I've stopped saying it now but if only we took the word "hospice" out and made it something else. But it's such a beautiful term used in the human field that we do need it. But in the animal world, it's starting to take on a different meaning. We've already discussed the negative part of it. But I honestly believe that our audience out there is loving the work that we do. They bring their heart and soul to these conversations. I don't think that's going to change, and hopefully it will grow more and more.
Karen Wylie: I hope so too. I think we need to reclaim hospice with what we call it and what we describe to people what it is, and what it can be. And provide the education that we know how to provide.
Kathryn Marocchino, PhD: Karen, can I ask something? I was really intrigued by what you mentioned, this whole new path that you're naming here. Am I reading this correctly? In other words, you're centering the focus on the relationship between the caregiver and the companion animal. So the focus is no longer on the veterinarian guiding the team.
Karen Wylie: That is correct. There is a new center to the universe. There is a new center to the interdisciplinary team concept. The veterinarian is not the primary decision-maker at the center of all this. The pet owner is because the pet owner, you know, may see a veterinarian for five minutes in an appointment but the other 23 hours and 55 minutes of the day, the pet owner is with her pet.
Kathryn Marocchino, PhD: There you go.
Karen Wylie: So the pet owner is at the center and is the primary decision-maker. I do not at all want to say we're not bringing in a veterinarian partner—
Kathryn Marocchino, PhD: Absolutely.
Karen Wylie: — to support us. We need that. For my own life, it's been very important to have veterinarians that I trust their problem-solving ability. That they know things I don't. And together, we can come up with a good path and good decisions for my pet. So that is our new approach, is that the pet parent is at the center, and the veterinarian partner is one of the others, like pet groomers, pet sitters, grief counselors, chaplains, everybody who can support the pet owner with her pet. That's the new team. That's the Circle of Care— that the pet parent is at the center with their pet.
Kathryn Marocchino, PhD: See, if you think about it, this is what Guy Hancock, for example, who was a vet but was very deeply steeped in human hospice, was envisioning. In other words, think about human hospice. You don't have this hospice doctor hovering over you all the time. Who is it that builds the hospice? It's the support team. Yes, there is a doctor who adjusts medication and gives advice. That person really doesn't even come to your home. It is the team. It is the people who actually support the patient.
Unless, of course, we have a veterinarian like Ella, and then of course that's a different story. But I understand what you're doing, and I think it makes perfect sense.
Ella Bittel, DVM: At the same time, I'm absolutely with you in terms of I believe animal hospice has existed for as long as humans were with animals. It happens in the relationship. It gets invented in the moment, and it will always, there will always be people who will be doing that. There are situations where it's do-able without major medical support. So those are the blessed ones that can do it and can understand how profound an experience that actually is.
I also have made images for my presentations that remind me quite a bit of what you're describing, you call it the "Relationship-centered Approach." It's actually taken directly from human hospice where they use that image where in the center is the patient and then around is the support team. I used that image and over-imposed the things that we do, at certain places, have available to help and support animal guardians. True, the doctor is just on the outside.
I always made an emphasis on this also in my online classes where, come on, how much of the care is done by whom, you know? I used a circle and was dividing it into pieces. It's like the owner is the main one! So yes, by supporting the owners and giving them the information that they need is definitely the main step that we can take in a good direction.
Karen Wylie: Hopefully, one step will lead to another step, will lead to another step. At least we can hope so.
Gail Pope: Baby steps!
Karen Wylie:Thank you to Kathryn and Ella for joining us and sharing the story behind the creation of the "Peaceful Quality of Dying Guide". Gail and I so enjoyed having the four of us together for this conversation.
And a quick reminder that enrollment is still open for our new course, "Relationship-Centered Animal Hospice". The response has been so wonderful that we've added a second class on Sundays. We'll put the link with all the details in the show notes below.
Karen Wylie: So thank you all for being with us here for Peace of Mind for Pet Parents. We hope you'll return next week. See you then. Bye-bye.
Ella Bittel, DVM: Bye!
Kathryn Marocchino, PhD: Thank you.
Gail Pope: Thank you, and see you soon.
KEY NOTES
- Understanding what is normal during the natural dying process
- Exploring natural dying and hospice-supported natural death
- Looking beyond scores and numbers when considering quality of life
- Honoring caregiver choice and the importance of adapting to each pet’s needs
- Preparing for end-of-life through education, awareness, and planning
- Keeping presence, love, and the human-animal relationship at the heart of hospice care
Frequently Asked Questions
What is the PEACEFUL Quality of Dying Guide?
The PEACEFUL Quality of Dying Guide: Signs of a Peaceful Passing is an educational resource created by Gail Pope, Dr. Ella Bittel, and Dr. Kathryn Marocchino to help pet caregivers better understand signs and changes that may occur during the natural dying process.
Why was the PEACEFUL Quality of Dying Guide created?
What is hospice-supported natural death for pets?
Does supporting natural death mean opposing euthanasia?
How is quality-of-life monitoring discussed in this episode?
Why is caregiver education important in animal hospice?
What is Relationship-Centered Animal Hospice?
Who can learn about Relationship-Centered Animal Hospice?
CHAPTER TIMESTAMPS
- 00:50 - Ten Years of the PEACEFUL Quality of Dying Guide
Gail Pope reunites with Dr. Kathryn Marocchino and Dr. Ella Bittel to reflect on how they found one another and why they created the PEACEFUL Guide. - 09:30 - Understanding the Natural Dying Process
A conversation about what caregivers may see as a pet approaches death, and how education can help make the natural dying process feel less frightening and unfamiliar. - 12:45 - Natural Death, Hospice & Quality of Life
Exploring hospice-supported natural death and why quality of life cannot always be captured by scores, numbers, or a single assessment. - 17:09 - Caregiver Choice, Adaptability & Preparation
Why there is no single path for every pet or family, and how preparation, education, and adaptability can help caregivers make choices that fit their individual circumstances. - 22:10 - Presence, Love & Relationship at the Heart of Hospice
A reflection on the importance of being present with our animals and recognizing that relationship, connection, and love are central to the hospice journey. - 30:06 - Looking Ahead: Relationship-Centered Animal Hospice
Karen and Gail share their evolving vision for Relationship-Centered Animal Hospice, placing the animal, caregiver, and their relationship at the heart of care, supported by a wider circle of support.
ENTITIES REFERENCED IN THIS EPISODE
- Animal Hospice Group (animalhospicegroup.com) — professional certification organization in animal hospice and palliative care
- BrightHaven Caregiver Academy (brightpathforpets.com) — caregiver education program for pet parents
- BrightHaven (brighthaven.org) — nonprofit animal hospice and caregiver education organization
- Karen Wylie, EdD — Executive Director of Animal Hospice Group, Co-Founder of BrightHaven Caregiver Academy
- Gail Pope — Founder of BrightHaven, author of The BrightHaven Way: Lessons from 700 Animal Teachers
- Nourishing Through Illness Ebook - offers gentle, practical guidance for pet caregivers navigating feeding challenges during chronic illness, difficult diagnoses, aging, and end-of-life care.
EPISODE METADATA
- Episode Number: 083
- Series: Peace of Mind for Pet Parents: Navigating Life with Aging or Ill Pets
- Produced by: BrightHaven Caregiver Academy
- Website: https://brightpathforpets.com
- Hosts: Karen Wylie, EdD; Gail Pope
- Topic Cluster: Preparing for the End: The Whole Journey
- Primary Keywords: Animal hospice; pet end-of-life care; natural dying; hospice-supported natural death; quality of life; caregiver education; Relationship-Centered Animal Hospice
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