Ask patients about their pets. This can build a bridge to talking about topics like functional status, home life, and family dynamics.
Across specialties a universal truth exists: if you want to get grumpy, frustrated patients to open up, ask them about their pets. We learned this early on as med students, when patients would share pictures of their pets. Pets sometimes were the strongest emotional support a patient had. Now, as resident physicians, we’re struck by the ability of pets to brighten the mood of even the prickliest patients and rescue conversations on the verge of breakdown. Beyond building rapport, asking a patient about their furry family members can yield valuable clinical information that may help us refine our diagnoses and give better care.
For example, while on the psychiatry service, a young woman’s mother finally opened up when asked how her family had come to get a dog. She shared that she thought a dog would make her daughter better, because who doesn’t love puppies? When my patient didn’t brighten or show interest in caring for her new pet, her parents knew that her depression had worsened to a point that intervention was needed.
Another patient denied any chest pain or trouble exercising, but mentioned that he’d been taking his beloved Labrador on shorter and shorter walks. We referred him for coronary evaluation, which revealed a tight atherosclerotic lesion that was stented. He’s now back to long walks with his pup. Beyond functional considerations, asking about pets also clue us into less common diagnoses, like tick-borne illnesses or zoonotic infections.
Yet another psychiatric patient, a chronically ill woman with more than 40 hospitalizations in two years, struggled to find motivation to stick with treatment. She wept when in the hospital, but felt hopeless about making change in her life. Our team spent time getting to know her and she talked a lot about her dog of eight years, who she always gave excellent care. We developed a treatment paradigm with psychotherapy focused on building concrete skills to help her reach her goal—namely staying well at home in order to care for her biggest support. We communicated this approach to her outpatient therapist and she hasn’t hospitalized since then.
Pets can also give patients and families purpose and perspective during end-of-life care. One woman with a terminal biliary cancer struggled with her family around thoughts of mortality and palliative care. The medical team offered her home hospice services focused on symptom reduction and pain control, but this sounded too much like “giving up.” By reframing her end-of-life care in terms of the amount and quality of time spent she would be able to spend with her Yorkshire Terrier, Fred, we developed a plan aimed at maximizing her happiness (and Fred’s) in her remaining days.
In short, asking patients about their furry friends supplies useful information and builds rapport in a multitude of clinical situations. For a patient, talking about their pets can be an escape from the hospital and a reminder of what might motivate them to stay in treatment. Pets can also provide a useful measurement of functionality in day-to-day life, with a myriad of clinical implications.
1. Ask patients about their pets as part of a routine social history.
2. Use open-ended questions about pets as bridges to topics like functional status, home life, and family dynamics.
This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.