Written Documents

Animal Hospice Support Documents

A collection of written documents to address challenges frequently encountered in the field of animal hospice, for use by animal guardians as well as veterinarians.

These documents are either authored by holistic veterinarian Ella Bittel, or co-authored by her in a collaborative effort of the founding members of GRACE Animal Hospice, i.e. the founders of BrightHaven, Spirits in Transition and the Nikki Hospice Foundation for Pets.

Please note that magazine articles and conference proceedings texts by Ella can be found under the menu item “Articles”.

PEACEFUL, the Quality of Dying Check List (GRACE)

PEACEFUL, the Quality of Dying Check list, is designed to determine acceptable quality of life for an animal in hospice care to continue the normal dying process. This document is authored by GRACE. On the contrary, Quality of Life scales are used in veterinary medicine to determine when to euthanize an animal. They are based on the belief that the usual signs of the normal dying process are unacceptable. This Quality of Dying checklist is designed for animals who receive hospice care to maintain their comfort all the way through an unhastened death. It is informed by the experiences of dying humans, which taught hospice that certain symptoms, even though they can be difficult for the family to witness, are actually not causing discomfort to the patient.

Click here to download this list.

Special-Needs Care or Hospice Certificate (GRACE)

We offer this downloadable form to those who have an animal receiving special needs care and/or hospice and to veterinarians who feel their clients could benefit from it. The intended use of the form is for animal caregivers to be able to address the concerns of family members, friends or neighbors if they question an animal’s care, given its appearance or condition. For example, some people are unaware that an old animal can be rather skinny even if it is still eating well. In that kind of a situation it might be helpful to show the form, explaining that the animal is under veterinary care and that what they are observing can be normal symptoms for the animal’s condition, also reassuring them that pain management gets implemented if needed.

Click here to download this form.

If the animal is in an area (e.g. pasture, yard, car) that can be viewed by others, consider also posting the form so that it is clearly displayed. If you offer animal hospice services and would like to distribute the form with your logo visible, please feel free to e-mail us and we will provide you with an according version of this form.

Foundational Principles of Hospice Care (GRACE)

The founding members of the GRACE consortium, have nearly 50 years of combined experience in hospice care for animal companions. We have found that human hospice principles are applicable and essential in animal hospice. If even one or more of these principles is not met, the effectiveness of the care given becomes so severely limited that euthanasia is almost inevitably the outcome.

Recommended Nomenclature of Services for Animal End-of-Life Care (GRACE)

These are detailed suggestions to veterinarians how to properly use the word “Hospice” when offering services. Since these suggestions have not been widely adopted by the veterinary profession, this document can also give insight to non-professional animal caregivers when cautiously navigating services advertised as veterinary hospice support.

Why is it important to distinguish the term “Hospice” from other types of End-of-Life Care?

The notion that it is superfluous to understand the difference between hospice and other types of end-of-life care for animals is prevalent among those viewing and advertising hospice as just another word for palliative care ending with euthanasia. The price paid for such approach can be high, for both the animal and its caregiver, as well as for our society. This is a succinct yet not all-encompassing list of the consequences when the term “hospice” is used without understanding and/or respect for the basic hospice values that have made human hospice the treasured resource it is today. Click here to view the list.

Will your veterinarian support you in hospice care? Questions may help to find out.

“Hospice” has become a buzz word of sorts in animal care. This has lead to a rather indiscriminate use of the term. Those looking for hospice support do well to engage in conversation with possible local animal hospice providers to find out about their perspectives and level of experience. We advise to do this in advance of a possible need, without the time pressure and emotional challenge that often sets in when decisions are to be made for an animal once it is diagnosed as terminally ill. Click here to view the questions.

SPIRITS in Transition Seminar Brochure

Click here to view the full seminar brochure as PDF, (file size: 1.3MB). This requires Adobe Acrobat Reader 5.0 or later. Please click here to download the newest version of Adobe Acrobat Reader. If you have trouble downloading the seminar brochure, please contact us at

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