This article is a part of our End-of-Life Care Resource Hub, which covers quality of life assessment, decision-making, planning your goodbye, and grief support. Browse all resources →
Introduction
“Is my pet still enjoying life?” is one of the most difficult questions pet owners face, especially when navigating chronic illness, progressive disease, or end-of-life decisions. The answer feels impossibly subjective—quality of life is personal, abstract, and constantly shifting.
The challenge is compounded by guilt, love, and fear. We want to see our pets as doing well because we love them. We’re afraid of what an honest assessment might reveal. And we worry about making the wrong decision, either acting too soon or waiting too long.
This is where quality of life assessment tools become invaluable. These structured frameworks help you evaluate your pet’s wellbeing across multiple dimensions, track changes over time, and have informed conversations with your veterinarian. They don’t make the decision for you—but they help you see the full picture more clearly, removing some of the ambiguity from an inherently emotional process.
What Are Quality of Life Assessments?
Quality of life assessments are structured questionnaires that evaluate specific aspects of your pet’s daily life and wellbeing. Rather than relying on a vague sense of “how they’re doing,” these tools ask targeted questions about behavior, comfort, mobility, appetite, and other key indicators.
The purpose is to quantify subjective observations, track changes over time, open dialogue with your veterinarian, remove some ambiguity from assessment, and identify specific problem areas that might be addressed through treatment or management.
These assessments are tools to support decision-making, not replacements for veterinary judgment or your intimate knowledge of your pet. Think of them as a structured way to organize what you’re already observing into actionable information.
CRITICAL MISCONCEPTION: “But They’re Still Eating and Drinking”
This is the most common misunderstanding we encounter:
Many owners believe that as long as their pet is still eating and drinking, their quality of life must be good.
Here’s the truth: Eating and drinking are biological survival functions—not indicators of quality of life.
A pet can be in significant pain, unable to move comfortably, no longer enjoying life, suffering from severe anxiety or confusion, or experiencing distressing symptoms—and still eat and drink. These are instinctive behaviors driven by survival mechanisms, not conscious enjoyment of life.
Quality of life is about more than survival. It’s about comfort, dignity, engagement with the world, freedom from distress, and the ability to experience pleasure. A pet who eats and drinks but can’t walk, play, interact, or rest comfortably is not experiencing good quality of life—they’re simply surviving.
This is why comprehensive assessment across multiple categories is essential. Nourishment is ONE data point among many, not the determining factor.
Why Honest Evaluation Matters
The most valuable quality of life assessment is an honest one, but honesty is harder than it sounds.
The temptation to grade generously is strong. We naturally want to see our pets as doing better than they are. Love makes us overlook subtle declines. Fear of the answer makes us avoid harsh truths. Guilt influences how we answer questions—if we admit things are bad, does that mean we should have acted sooner?
But honesty serves your pet. An inaccurate assessment delays needed care, pain management adjustments, or important conversations with your veterinarian. Your pet depends on you to advocate for their comfort, and tracking requires consistent, truthful baselines. Your veterinarian needs accurate information to help effectively.
An honest assessment isn’t about being pessimistic or giving up. It’s about seeing your pet’s reality clearly so you can make informed decisions about their care. If the assessment reveals concerning patterns, that’s valuable information that can lead to better pain management, treatment adjustments, or clarity about where you are in your pet’s journey.
Why Many Assessments Use Negative Phrasing
You’ll notice many quality of life questions are phrased negatively: “My pet does not want to play” rather than “My pet wants to play.”
This is intentional. Negative phrasing helps overcome our natural optimism bias. When a question asks “My pet does not want to play,” you’re forced to honestly assess the absence of behavior rather than convince yourself the behavior is still present. If you’re thinking “Well, they don’t play as much as before, but they still play sometimes,” that’s meaningful data—not a full disagreement with the statement.
The goal isn’t to make you feel bad—it’s to help you see clearly.
Remember: There are no “wrong” answers. Whatever you’re observing is valid and important.
Digital vs. Paper: Choosing Your Assessment Approach
Quality of life assessments come in two main formats: traditional paper questionnaires and digital tracking apps. Both serve the same purpose—helping you monitor your pet’s wellbeing over time—but they work very differently.
Hospet: The Digital Solution
Hospet (www.hospet.app) is a free mobile app available for both iOS and Android that was built by Healing Touch specifically to replace paper questionnaires and solve their biggest limitation: the inability to easily see trends over time.
What makes Hospet powerful:
Built-in Quality of Life Assessments: Complete structured assessments directly in the app—no paper, no manual calculations. The app guides you through comprehensive evaluation across all key categories of your pet’s wellbeing.
Automatic trend visualization: This is the game-changer. Hospet graphs your pet’s quality of life scores over time, making patterns instantly visible. You can see at a glance whether your pet is stable, improving, or declining—something that’s nearly impossible to track accurately with paper forms.
Daily ratings: Quick check-ins between full assessments help you catch changes early. Free users can track overall health, while Premium users can customize and monitor unlimited categories with reminders to stay consistent.
Comprehensive event tracking: Log symptoms, behaviors, medications, and vet visits all in one place. Choose from over 90 built-in event types or create your own, so your tracking reflects your pet’s real life. Use these events to spot changes, track routines, coordinate care, and better understand what your pet experiences day to day.
Share with your support team: Email assessment results and tracking data directly to your veterinarian, pet doula, or other care providers with a single click. This makes it easy to keep everyone aligned and informed without trying to remember or verbally describe what you’ve been observing.
End-of-life planning tools: Track bucket list items, set goals, and document your pet’s care preferences. Hospet helps you stay organized and focused on what matters most, ensuring you and your pet’s support team are aligned every step of the way.
The key advantage: Paper questionnaires require you to manually save, organize, and compare scores across time to spot trends—a tedious process that most people don’t maintain consistently. Hospet does this automatically with visual graphs, making it much easier to see whether your pet’s condition is stable, improving, or declining. The difference between looking at numbers on separate pieces of paper versus seeing a visual trend line is profound.
We strongly recommend Hospet for ongoing monitoring because it eliminates the manual work of tracking and comparing results, and the visual timeline makes patterns immediately clear that would be invisible otherwise.
Paper Questionnaires: The Traditional Approach
For those who prefer a non-digital option or want a one-time assessment, paper questionnaires remain valuable.
Our Quality of Life Questionnaire:
We offer a comprehensive assessment adapted from The Ohio State University Veterinary Medical Center’s materials. You can download it as a PDF and complete it on paper.
What it evaluates: Seven key categories with a total of 150 possible points:
- Attitude/Behavior (40 points) – How your pet engages with life
- Discomfort (20 points) – Signs of pain or physical distress
- Nourishment (20 points) – Eating and drinking patterns
- Elimination (20 points) – Bathroom habits and control
- Movement (20 points) – Mobility and activity levels
- Hygiene (10 points) – Self-care and grooming
- Other (20 points) – Impact on family and caregivers
How it works: Each question uses a 1-5 scale where higher scores indicate better quality of life. If any category scores less than 50% of its total points, this signals a significant concern warranting veterinary consultation.
Download our assessment: Quality of Life Assessment
Best for: One-time evaluations, those uncomfortable with technology, printing to discuss with family members, or establishing a baseline before considering digital tracking.
The limitation: You’ll need to manually save and compare multiple completed forms over time to identify trends, which requires significant effort and organization that digital solutions handle automatically.
Other Established Tools
The HHHHHMM Scale (Villalobos Scale) Developed by Dr. Alice Villalobos, this widely-used assessment evaluates: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. Available free online.
Ohio State University Assessment Comprehensive visual scale (the foundation for our questionnaire), available in both chart and questionnaire formats.
Our recommendation: Start with whichever format feels right to you. If you begin with paper and find yourself wanting better trend visualization, Hospet is always available as the next step.
When and How Often to Assess
Establishing A Baseline
Complete a quality of life assessment as soon as you’re aware of a chronic condition, terminal diagnosis, or noticeable decline in your pet’s wellbeing. This establishes your baseline for comparison—a starting point that gives meaning to future assessments.
Frequency Changes as Conditions Progress
Assessment frequency should match the rate of change you’re observing in your pet:
Early in diagnosis or with stable conditions:
Monthly assessments are typically sufficient when your pet’s condition is relatively stable. Changes are gradual and subtle at this stage. This establishes a long-term tracking pattern that helps you recognize when things begin to shift.
As disease progresses:
Move to weekly assessments when you start noticing more frequent shifts in behavior, comfort, or function. At this stage, you’re tracking accelerating changes, monitoring treatment responses more closely, and the euthanasia window may be approaching. Weekly data helps you see patterns that would be invisible with monthly check-ins.
During rapid decline or crisis:
Daily assessments—or even multiple times per day—become important when your pet’s condition is changing noticeably day to day. You’re actively trying to determine if it’s time for intervention or end-of-life decisions. Every data point helps inform urgent decisions with clarity that gut feeling alone can’t provide.
The guiding principle: Assess as frequently as the situation warrants. If you find yourself thinking “something seems different today” or “I’m not sure if things are getting worse”—that’s when you assess. Don’t wait for your scheduled time if your instinct is telling you to check in.
Why digital tracking helps: Apps like Hospet make frequent assessment practical because they don’t require manual score calculations, storage of paper forms, or mental comparison across dates. You can complete a quick daily rating in seconds or a full assessment in minutes, with all your historical data instantly accessible.
When Assessment Suggests Veterinary Consultation
If your quality of life assessment reveals concerning scores or troubling patterns, professional evaluation can help.
Your primary veterinarian can discuss results, explore treatment options, adjust pain management, or recommend diagnostic work to address specific problems the assessment has identified.
Our Quality of Life Consultation is a dedicated appointment focused entirely on assessing your pet’s wellbeing and discussing your options. Unlike a standard exam, this consultation takes time to evaluate your pet in their home environment and have an in-depth conversation about their condition and your concerns.
During a quality of life consultation, a veterinarian specializing in end-of-life care will perform a comprehensive physical examination in your home, review your quality of life assessment data, discuss pain management and comfort care options, help you understand your pet’s condition and prognosis, and provide guidance without pressure or judgment.
Learn about our Quality of Life Consultation service
If you prefer an in-home evaluation by a veterinarian specializing in end-of-life care, we’re here to support you through this process.
Using Assessments as a Conversation Tool
Quality of life assessments are most powerful as conversation starters, not final verdicts.
With your veterinarian: “Here’s what I’ve been observing over the past few weeks. Can we talk about what these changes might mean and whether there are treatment adjustments we should consider?”
With family members: “Let’s each complete this assessment separately and then compare our observations. Are we all seeing the same things, or are some of us noticing changes others haven’t picked up on?”
For your own clarity: “Three months ago my pet scored 130/150. Today they scored 95/150. The downward trend is clear even if no single day feels dramatically different.”
The goal isn’t to reach a specific number that “proves” it’s time for euthanasia. The goal is to see patterns clearly, identify specific problems that might be addressed, and make informed decisions about care based on data rather than just emotion.
Final Thoughts
Quality of life assessments don’t make difficult decisions easier—the decision to say goodbye will always be heartbreaking. But they do make decisions clearer. By providing structure to evaluate your pet’s wellbeing objectively, these tools help you move from vague worry to specific understanding. And that understanding empowers you to advocate for your pet’s comfort and dignity with confidence.
References
This article draws on resources from:
- The Ohio State University Veterinary Medical Center – “How Do I Know When It’s Time? Assessing Quality of Life for Your Companion Animal and Making End-of-Life Decisions”
- Dr. Alice Villalobos – HHHHHMM Quality of Life Scale
- Hospet mobile app – www.hospet.app
- Healing Touch Pet Care Quality of Life Questionnaire (adapted from Ohio State University materials)
For more information on quality of life assessment, visit the International Association for Animal Hospice and Palliative Care (IAAHPC) at iaahpc.org.