Page 383 - WSAVA2018
P. 383

WSV18-0144
ANIMAL WELLNESS & WELFARE
MAXIMIZING QUALTY OF LIFE OF ILL PATIENTS
F. McMillan1
1Best Friends Animal Society, Animal Care, Kanab- UT, USA
MAXIMIZING QUALITY OF LIFE OF ILL PATIENTS
Franklin D. McMillan, DVM, DACAW
Best Friends Animal Society, Kanab, Utah, USA, email: dr.frank@bestfriends.org
WHAT DO WE MEAN BY QUALITY OF LIFE?
Despite the strong sense that we understand what
QOL is, the term currently defies precise description. This is because QOL is a personal, private, subjective experience, has no ‘normal,’ ‘average,’ or any other frame of reference, lacks any units of measurement, and means different things to different people.In animals, QOL is
not restricted to what kind of housing the animal has, the type of food he gets, the luxuriousness of her bed, the number of walks he gets per day, what size of yard she has to play in, whether he goes to doggie day care or stays home alone all day, or whether she has animal companions to play with. And most important, it is not restricted to—or equivalent to—his health status. It is
a compilation of all of these factors and more, and the animal’s reaction to and feelings about them. So what do we mean by quality of life in animals? It can best be understood as one’s level of enjoyment of life. In this way, we can view QOL in many ways as very similar (though not quite identical) to happiness.THE FEELINGS OF QUALITY OF LIFE
Quality of life in animals appears to be comprised of the balance between pleasant and unpleasant feeling states – known as the affect balance model. In this view, QOL may be seen as a scales, with pleasant feelings on one side and unpleasant on the other. The direction of tipping of the scales represents the individual’s QOL. Quality of life increases when the balance tips toward the pleasant feelings, and declines when the balance tips toward unpleasant feelings. A key feature of the affect blanace model of QOL is that it becomes very clear as to which factors in life contribute to QOL. Anything which tips
the QOL scales—in either direction—plays a role in the animal’s QOL, but those things that do not tip the scales do not affect the animal’s QOL. MAJOR CONTRIBUTING FACTORS TO QUALITY OF LIFE
Several factors contribute to QOL, all having their influence through their associated pleasant and unpleasant feelings. Those with the greatest influence include:
l Social relationships—Social bonds are promoted and
enforced by pleasant and unpleasant emotions. Positive social affiliations and companionship elicit pleasant feelings, and separation and isolation elicit unpleasant feelings.
l Mental stimulation—Monotonous, unchanging environments elicit highly unpleasant feelings of boredom. Conversely, pleasant feelings are elicited by stimulation, challenges, and mental engagement.
l Health—Compromised health involves a wide array
of unpleasant feelings. Physical disabilities limit one’s opportunities for experiencing pleasurable feeling states.
l Food intake—The pleasant taste of food and the unpleasant feeling of hunger both motivate consumption of nutrition to support life, and both may contribute the animal’s QOL.
l “Stress”—As a contributing factor to QOL, stress refers broadlt to specific unpleasant emotions such as fear, anxiety, loneliness, boredom, and anger. Its influence on QOL is through the feelings associated with these emotions.
l Control—In animals and humans, one of the strongest predictors of well-being is the perception of control over meaningful aspects of one’s life. The opposite—a sense of lack of control—is associated with feelings of helplessness and depression, and lowered enjoyment of life.
MAXIMIZING QUALITY OF LIFE – GENERAL PRINCI- PLES
Maximizing QOL can be summarized by a single principle: Tip the QOL scales as far toward the pleasant side as possible. Based on the balance model of QOL, this may be achieved by minimizing unpleasant feelings, promoting pleasant feelings, or a combination of the two. This basic principle applies to all animals, healthy and ill. For animals with a health disorder the main effort is to restore a diminished QOL by alleviating the unpleasant feelings associated with the disease. For animals with disabilities, this most often means restoring or replacing the impaired function in order to regain lost pleasures in life. For healthy animals, the main emphasis is promoting pleasures. In all cases, QOL rises as the scales tip increasingly toward the positive direction.
MAXIMIZING QUALITY OF LIFE IN THE ILL ANIMAL
In the ill animal the QOL balance is tipped toward the unpleasant side because of (1) the increase in unpleasant feelings associated with the disease state, which may consist of a single high-intensity discomfort or multiple low-intensity discomforts; (2) a diminished ability to enjoy pleasant feelings and experiences due to the tendency of unpleasant feelings to focus attention progressively more on the discomfort and progressively less on pleasant feelings; and (3) the impaired opportunities to experience pleasure due to the disabilities associated with the medical disorder. Because of the powerful
Your Singapore, the Tropical Garden City
          381
            




































































   381   382   383   384   385