When a child's BFF can't live up to its title: Talking to kids about euthanasia
As a hospice veterinarian at Paws into Grace in San Diego, California, Jessica Vogelsang, DVM, is an expert when it comes to end-of-life veterinary care. But until somewhat recently, she wasn’t so skilled at having euthanasia conversations with kids.
“My shortcomings were revealed when I had to explain euthanasia to my own upset and confused kids,” says Dr. Vogelsang. “I had no idea what I was doing. Pulling from my Catholic school background, I tried to explain the concept of heaven, to which my son responded, ‘Who’s Kevin, and why does he have our dog?’” (Dr. Vogelsang later drew on that experience when she published her first book.)
It became painfully clear to Dr. Vogelsang that she wasn’t doing clients any favors by giving them her default how-to-tell-the-kids advice: “Tell them whatever feels right.” Her clients didn’t know what was right. They didn’t know where to start or what was appropriate. They needed more concrete guidance.
Dr. Vogelsang’s first piece of advice is to start early. “As soon as you know a pet has a terminal illness, start talking about the end-of-life process,” she says. “Plant the seed by saying, ‘I know you have kids. Have you thought about how you want to handle telling them?’ Most people wait until the day of the euthanasia to talk to their children, which is a difficult time to start laying the groundwork.”
The next step is to provide tools, like this handout on general communication tips, age-specific advice and ideas for celebrating and memorializing pets. Help parents see they have an opportunity to teach and model appropriate grieving to their children, who may be encountering bereavement for the first time.
“My favorite situations are when you have kids who’ve been prepared early on and who want to go through some sort of ceremony beforehand—maybe they’ll write a letter or light some candles—and you’ll just see them really involved in the process. It’s beautiful for them, and it’s absolutely astonishing to watch the calming effect it has on the parents,” says Dr. Vogelsang.
You don’t always have the luxury of planting a seed early on, but you can still be ready to provide advice and support on the day of the euthanasia. If you end up being the one to break the news to a child, the same general communication tips from this handout apply. Don’t sugarcoat what’s happening with vague expressions like, “Spot is going to sleep for a long time.” Say, “I’ve done everything I can do, but Spot won’t get better. I will give him a shot that stops his heart from beating. He won’t feel any pain.”
Explain to parents that up until almost age 5, kids are typically more in tune with their parents’ emotions than their own, says Dani McVety, DVM, owner of Lap of Love Veterinary Hospice and In-Home Euthanasia in Lutz, Florida. They may not want their child present during the euthanasia so they can experience their emotions in full without worrying about their child’s interpretation.
Dr. Vogelsang has a box of crafts on hand for every euthanasia appointment where children are present. It’s full of things children can do to express themselves and stay occupied, like collage, drawing and letter-writing materials and bubbles. “I let them pick what feels most comforting,” she says.
According to Dr. McVety, “Teenagers can be one of the most difficult age ranges to talk to because they have an altruistic view of society and want to fight through what’s happening. I try to talk to the teenager directly because you can see parents get very defensive—particularly when they’re already grieving.”
Dr. McVety tries to meet teenagers where they are by saying something like, “I understand you feel like we’re giving up. But let’s talk about what we can’t do and what we can do. We can’t keep coming back to the emergency room. We can’t risk a potentially difficult passing. We can provide the most peaceful euthanasia, and that’s why I’m here.”
Helping parents and children in this way may seem difficult to juggle in addition to your other tasks, but Vogelsang sees it as a veterinarian’s duty: “If we are asking people to take on the responsibility of making this decision for their pets, we owe it to them to provide tools to manage the emotions involved.” (We also owe it to clients to help them know when it's time. Here's a client-facing video that can help owners navigate this difficult decision).