Considering Alternative Living Arrangements In Response To A Health Concern
We know that companionship and access to an interesting and diverse living space are important parts of caring for sanctuary residents, but what if your veterinarian recommends a living situation that requires moving a resident away from their companions or into a smaller space due to specific medical concerns, or your caregiving team worries that a resident’s current living arrangement puts them at risk due to certain health challenges? Because every resident is an individual and each situation will have its own specifics, it’s important to consider alternative living arrangements on a case-by-case basis. In this resource, we’ll talk about the some of the more common alternative living arrangements that you may need to consider for a resident who is injured or ill, things to think about when deciding if this living arrangement is in the best interest of your residents, and modifications you can make to minimize some of the adverse effects these living arrangements may have on your residents’ overall well-being.
Alternative Living Arrangements
While there are a variety of specific recommendations your veterinarian might make in regards to alternative living arrangements due to a certain health condition, they typically fall into one of the following categories (or a combination of these):
- Quarantine– Quarantine is typically thought of when discussing new residents. These individuals are housed separately from other residents for a set period of time (with the possible exception of individuals they arrived with) in order to protect other residents from any diseases they may be carrying, potentially without the newcomers showing signs of illness. There may be other times when your veterinarian recommends quarantining long-term residents, such as in the event that they were potentially exposed to a particular disease.
- Isolation– If a resident is showing signs of illness or has tested positive for a certain disease, your veterinarian may recommend isolation to prevent spreading the disease to other residents. The big difference between isolation and quarantine is typically that, in the case of isolation, the resident is either clinically ill or confirmed to have a certain disease, whereas quarantine is a preventative measure in the event that a resident may have a contagious health issue. Because quarantine is often associated with new residents, and it is quite common for new residents to arrive showing clear signs of illness, the line between quarantine and isolation is sometimes blurred.
- Living Arrangements That Limit Mobility– If residents have certain injuries or health challenges, your veterinarian may recommend cage rest or stall rest, depending on the species or size of the resident, or they may recommend preventing certain types of activities (for example, a duck resident with a leg injury may need their activity restricted on land, but swimming is encouraged). The basic idea here is that, due to a particular health challenge, the resident will benefit from less activity or less of certain types of activities, which is often facilitated by restricting their physical space in terms of the size of the space, the type of space, or both.
- Living Arrangements That Restrict Physical Access To Companions– Your veterinarian may recommend that residents with certain health challenges be housed away from other residents, not to prevent the spread of disease, as in isolation, but for the individual’s well-being. Individuals who are very weak due to illness or who are recovering from a surgical procedure may be at risk of being further injured by other residents, or there may be concerns that other residents will interfere with the individual’s recovery or current treatment. In other instances, closely monitoring the individual’s food and water intake or their urinary and fecal output may be difficult if they are living with other residents.
How To Decide If An Alternative Living Arrangement Is The Right Choice
We always recommend quarantining new residents, but there may be other times when you will need to consider whether or not to implement an alternative living arrangement for one of your residents. Depending on the situation, it can be difficult to know what is the best choice. We suggest having a discussion with your veterinarian as well as the sanctuary’s care team to thoroughly assess how to move forward.
Consider The Goal
Make sure you clearly understand the reasoning behind any recommendation for an alternative living arrangement. Common goals include:
- Preventing the spread of disease
- Protecting the individual from other residents or situations while they are in a vulnerable state
- Facilitating healing or reducing physical discomfort by limiting the individual’s physical activity or access to certain types of spaces
- Allowing for closer observation
Consider The Timeline
Are they recommending this alternative living arrangement on a temporary basis or a permanent one? Temporarily housing a resident away from their companions or restricting the amount or type of space they have access to are very different than doing so for the remainder of their life. Make sure you know approximately how long the alternative living arrangement will be needed.
Consider The Risk To The Individual If Not Offered An Alternative Living Arrangement
Make sure you understand the potential risk to the individual if you decide not to implement the alternative living arrangement. Consider the worst possible scenario, how likely it is to occur, and if it is a responsible risk to take.
Consider The Risk To Other Residents If They Continue To Live With The Affected Individual
Just as you need to understand any potential risks to the individual, you also need to understand any potential risk to other residents if an alternative living arrangement is not implemented. While you may think all contagious issues warrant isolation, in practice, you may find this is not necessary or always the best course of action. Many of these decisions will come down to your sanctuary’s Philosophy of Care. Again, it can be helpful to consider the worst case scenario, how likely it is to occur, and if it is a responsible risk to take. Be sure you know the answers to the following questions, and if you do not, have a conversation with your veterinarian. You might wish to ask your veterinarian:
- Is this health condition contagious? To whom?
- How likely is it that the individual’s companions have already been exposed?
- Are certain residents more or less at risk of either contracting the disease or being impacted by it? If so, whom?
- Is this condition curable? If not, is it manageable and what does management or treatment entail?
- How serious is this health condition? Is it potentially life-threatening?
Consider How You Will Assess If The Alternative Living Arrangement Is Helping
What indicators are you looking for to determine whether or not the alternative living arrangement is successful? This may include looking for certain improvements in the individual’s symptoms or health, or it may mean looking at other residents for signs that a contagious issue has spread beyond the first individual affected.
Consider How The Resident’s Quality Of Life Will Be Affected
Take some time to think about how the individual will respond to the alternative living arrangement. Be sure to consider both their current situation as well as their personality, preferences, and friendships. A resident who is fearful of humans and very bonded to a particular companion may not do well if completely separated from them.
Consider The Impact On The Resident’s Long-Term Well-Being
For a moment, set aside any concerns about the immediate impact an alternative living arrangement will have on the individual’s quality of life, and ask yourself how the individual’s long-term well-being will be impacted by offering an alternative living arrangement. Are they likely to make a full recovery after temporarily offering an alternative living arrangement? Will successful resolution of the current health challenge have an overall positive impact on the resident’s life, and is that resolution unlikely without implementing an alternative living arrangement?
Be sure to consider the individual’s overall health when thinking about their long-term well-being. Perhaps an alternative living arrangement will be helpful for a specific health issue they are facing, but if they also have a chronic degenerative condition, or a terminal illness that is progressively impacting their quality of life, even a fairly short period of isolation or living in a very restricted environment may not be a reasonable trade-off. This is especially true if you are worried that their quality of life will continue to decline due to other health challenges during their isolation period.
Consider If There Is An Alternative That Mitigates Some Of The Negative Impacts On The Individual
Taking all of the above information into consideration, is there an alternative solution that can achieve a similar goal while addressing potentially negative consequences? Be sure to think back to how the individual’s quality of life will be impacted, and brainstorm ways to mitigate any negative impact. Some things to consider:
- Is there a less restrictive way to reach the same end goal?
- Will this living arrangement cause the individual (or their close companions or family members) distress? Is there a way to prevent or lessen this distress?
- Are there other measures besides isolation of an individual that can be taken to protect residents from possible disease spread?
- Are there certain individuals who could safely live with the affected individual?
Putting It All Together
Because of all the variables involved when making decisions about implementing alternative living spaces, it’s impossible to offer a set of strict rules to follow. However, here is an idea of how the decision process works. Names in parentheses indicate that this particular outcome is illustrated in one of the examples below.
Let’s look at a few examples of situations where an alternative living arrangement may be considered due to a health challenge. Remember, every situation is going to be different, so even though we are talking about specific health issues in these examples, that does not mean the outcome in the example is always going to be the best thing to do.
Recently, Gilbert has been showing signs of having resistant Barber pole worms. Because of the risk to his herdmates if he continues to shed these resistant parasites in their shared living space, his veterinarian recommends isolating him from his herd. Though his caregivers do not want to separate him from his companions, they feel they have no choice but to move him to a different living space because there is no cure or treatment for his condition, and it is likely to spread to other residents.
In order to manage his parasite load, his veterinarian recommends housing him on a “dry lot” to prevent him from grazing or eating off of the ground. Because of the negative impacts of separating him from his herd, his caregivers are reluctant to also keep him in a barren living space. Considering the ultimate goal is to prevent him from eating off the ground, the caregivers decide to move him to a pasture that has many goat-safe trees and other tall vegetation for him to eat. Though this does not eliminate the risk of him eating off the ground, they hope that he will be less likely to do so because of the variety of tall vegetation in the space. This space also happens to be home to two docile potbellied pigs, Raymond and Marge. Because pigs are not affected by Barber Pole worm, Raymond and Marge can safely live with Gilbert, and luckily all three have very easy going personalities so they seem to be a good match for each other.
The staff regularly evaluate Gilbert through fecal testing and blood work to monitor his parasite load, packed cell volume, and total protein. They are able to determine that his new living situation seems to be helping because his parasite load has remained low, and he is not showing clinical signs of disease. Though resistant parasites are a growing concern, so far no other residents have shown the same degree of parasite resistance as Gilbert.
Lucy is showing signs of dry fowl pox, but no one else in the flock is showing signs of infection. While working with their veterinarian to confirm Lucy has fowl pox, her caregivers isolate her in the event that her flockmates have not yet been exposed. Within a few days of isolating Lucy, multiple other members of her flock are showing signs of dry pox as well. Because the virus has already spread to other members of the flock, Lucy’s caregivers decide to move her back in with her flock and implement measures to prevent the spread of fowl pox to other resident bird areas. They are also discussing whether or not they should consider vaccinating individuals who are not yet showing signs of illness.
Petunia is showing signs of a Mycoplasma gallisepticum infection. Her sinuses are swollen, but her appetite is normal, and she appears to be doing fine with the flock. Because Mycoplasma gallisepticum is considered ubiquitous, the assumption is that all of the sanctuary’s avian residents have already been exposed to the disease. Since Petunia is not posing a risk to her companions and she does not currently require an alternative living space for her recovery, her caregivers will treat Petunia with antibiotics while she remains with her flock. They will closely monitor her and only move her to another living space if it seems to be in her best interest.
Matilda recently underwent surgery to remove a reproductive tract tumor. She currently has a sutured incision that is healing. Her veterinarian recommends keeping her in a small pen in order to limit her movement to facilitate healing. They also recommend keeping her separate from other residents while she heals, as any roughhousing could result in complications and delayed healing. Matilda is not typically fearful of humans, but is clearly distressed being separated from her flock. When caregivers enter her pen, she tries to run away, no matter how slowly her caregivers approach. She is currently living in a pen in the same structure as her flock because her caregivers thought it would give her comfort to have visual access to the group, but every time they leave the enclosure to go out to their pasture, she vocalizes and starts pacing.
Not only are caregivers concerned about her emotional well-being, they are also concerned that despite being confined to a pen, she may still overexert herself due to her distress. Her best friend, Jane, is very sweet and mild-mannered and is unlikely to roughhouse with Matilda or otherwise cause damage to her healing incision. The caregivers decide to move Matilda and Jane to a pen in a different structure that has a small grassy yard. The two are quite content living in their own space, and though Matilda now has a companion and more space than originally recommended, she is actually less at risk of damaging her incision because she no longer runs or paces out of distress.
Winston is a giant Holstein who started showing signs of osteoarthritis a few years ago. Up until recently, his current pain management plan has kept him comfortable, and he has been able to keep up with the rest of the herd. Recently, his caregivers have noticed that he is having difficulty walking up some of the hills in the herd’s pastures, and if he lays down on any sort of slope, he sometimes has difficulty getting up again. They have discussed his situation with their veterinarian, but she does not have any additional treatments to offer. Instead, she suggests finding a way to keep him away from the types of terrain that cause him trouble. Because the caregivers have seen other cow residents develop similar issues as they age, the sanctuary has a separate cow living space for more senior residents or those with other health challenges that make keeping up with the main cow herd more difficult. This area offers a flat pasture that is immediately next to the indoor living space. This set-up minimizes the need to walk long distances in order to graze, and its flat terrain is easier for those with mobility issues to navigate. The caregivers are able to move Winston and his best friend, Andy, into the smaller herd where they both seem very happy to spend less time traveling and more time grazing and relaxing.
Keep in mind that every situation will be different, so be sure to think through the specifics of each case. Even in cases where two residents have the same health condition, you may find that what is in the best interest of one individual, may not be the right choice for the other due to their unique personalities, relationships, or overall health. Regardless of the decision you and your caregiving team make, be sure to evaluate the outcome and make changes as needed!