The Gentle Journey Quality-of-Life Tool

The Gentle Journey QOL Tool offers a comprehensive and compassionate approach to assessing your pet’s quality-of-life. This tool considers key factors like comfort, happiness, and well-being, guiding pet owners in making informed decisions about their beloved companion’s care.

Read each item below and give a score based on which best describes your pet’s current condition. Go with your gut feeling — don’t ruminate and parse each section. Read through once or twice and rate a 5, 3, or 1.

Scoring for each item is as follows:

5 points: Everything is “normal,” with no or very minimal change from when they were young adults and healthier. They may or may not be on any medications at this time. You have ticked off the positive comments and few if any of the negative comments. You feel good about this item.

3 points: Things have changed somewhat, but we have made some alterations in the environment, care, or medications to help them, and they are doing better but not perfectly normal. Perhaps you have not taken them in for care yet, are unsure about what to do, feeling a little worried or anxious, and/or wondering if something can be done to help your pet. Some of the good and only a few of the negative things in this section apply to your pet or your situation.

1 point: Your pet is struggling. They may not be on medication, but even if they are taking medications and/or receiving many other care changes, your pet is still having significant issues in this area. You are genuinely concerned and having difficulty managing their care. Things need to change, and if we cannot manage this item, we may need to help your pet pass peacefully. Many of the negative things in this section apply to you or your pet.

G is for Grooming:

G Score

  • Does your pet groom themselves and are they still doing a good job, or allowing the groomer or you to care for their appearance?
  • Do they look and smell clean and healthy?

  • Are you asking your groomer to do a hygiene clip or asking for a shorter cut because they don’t like you to brush them anymore?
  • Do they get overwhelmed/stressed out at the groomer or get home and need a day to recover?
  • Are they matted, unkempt, greasy, smelly, or the coat dull, patchy, or thinning?
  • Are there any lumps or bumps now? Are they bleeding or infected?
  • Are they overgrooming any areas?

E is for Engagement:

E Score

  • Does your pet enjoy spending time with your family?
  • Do they enjoy company visiting as usual?

  • Do they get irritated and snippy now with other pets or family members?
  • Do they avoid company? Are they exhausted when they leave, and/or do they wander off to a quieter part of the house when people are home? (If they never have liked visitors, ignore this question unless they used to get very worked up about visitors and now are ignoring them, or oppositely they used to ignore them but are acting out with them visiting, such as growling, barking, snipping).

N is for Nutrition:

N Score

  • Is your pet eating normally, and do they still enjoy eating their usual diet and treats?

  • Has their eating pattern changed? Are they eating less of their usual diet, taking longer to finish it, are they wanting canned food or table food now, or are you having to try a variety of different items to get them to eat?
  • Do they beg for more food, or perhaps losing weight even if they are eating the same or more than usual?
  • Did your veterinarian have you change their diet due to a disease process, or Is your pet on appetite stimulants, antinausea, or antiemetic (to stop vomiting) medications.

T is for Tools:

T Score

  • Do you have the tools you need to care for your pet, and do you have it down to an art form or a smooth-running machine?

  • Have you: Needed new items to help them function like a ramp, wheelie cart, harness, other mobility items or needed a helper to carry them outside or to get them into your vehicle?
  • Created a special area in the house just for them with good footing, no objects to get stuck under, indoor potty area/special or modified litter box away from other activity or for ease of access, special feeding station/change of size and depth of bowls now that are easier to access?
  • Have you created a spreadsheet to ensure you gave all their medications or to monitor their bathroom habits and have you been looking at other quality of life scales already?
  • Has your veterinarian suggested articles to read (or have you been searching) about your pet’s illness or anything to support your journey?

L is for Lines in the Sand:

L Score

  • Do you feel good about your pet’s and your current lifestyle?
  • Do you feel you are doing justice by your pet?

  • Are there things your pet is doing that are incompatible for safety or hygiene? (Such as a pet who is eliminating in the house and you have other pets or family members coming into contact with it.)
  • Is there something looming on the horizon you want to avoid happening or when it happens, you’ll know that it’s time?
  • Are you worried about a crisis situation related to your pet’s medical issues?

E is for Enthusiasm:

E Score

  • What have been the 5 things they really enjoy doing and are they still doing at least 3 of them with some of their old gusto? (This can be anything they enjoy other than eating.)
  • Can your pet chase after a toy, go for a hike, swim, or run on the beach?
  • Are they still tearing their stuffies apart or carrying them around?
  • Are they playing keep away and fetch?
  • Can they chase the laser beam or roll around in the catnip?
  • Is their energy level and enthusiasm fine?

  • Has their enthusiasm waned, or do they tire easily and stop playing much sooner than they used to? 
  • Has their walking routine changed and is the walk getting shorter or slower?
  • Are they taking longer to recover after activity, such as breathing harder or sleeping longer?
  • Are they not playful anymore?

J is for Jumping For Joy:

J Score

  • Do they race around with excitement when you get home?
  • Do they seek you out to go for a walk or chase a toy?
  • Are they getting up on the couch with you to snuggle?
  • Do they still try to counter surf or get on the counters or table?
  • Do they climb their cat tree?
  • Can they get around the house easily, going upstairs with you at night/no trouble coming down in the morning, or using stairs to get outside?
  • Do they like to wander around the yard or neighborhood on a sniffari?
  • Do they still enjoy car rides or other adventures?

  • Do you need to lift them up to get them on their feet or onto the couch or have you installed pet steps, ramps, or throw rugs so they can get around more easily?
  • Are you assisting them with the stairs or blocking the stairs off?
  • Do they need more and more medications for pain relief?  
  • Would you describe them as listless or lethargic, or that they sleep all the time?

O is for Open-Minded and Outgoing:

O Score

  • Is your pet docile, adaptable, do they go with the flow, everything well-tolerated by them and they still have an easy-going nature? Do they enjoy a change of scenery, adventure, or handle a change of schedule well?
  • Does your pet have a good relationship with: Their veterinary team, their groomer, their pet sitter/daycare/boarding facility?
  • Do they tolerate being given medications, subcutaneous fluids, using mobility aids?

  • Are they irritable and inflexible and have a low budget for medical intervention? Do they get agitated/snippy/need sedation/need a muzzle/are no longer welcome at their veterinarian/groomer/boarding facility/pet sitter?
  • Are they anxious during thunderstorms, at night, or when you leave the house?

U is for Uncomfortable:

U Score

  • Are they sleeping like they usually do-the same duration, not restless, no change in nighttime or daytime sleeping patterns?

  • Are they limping, toe touching on one foot, or holding up a limb at all?
  • Do they take a long time to lay down and get settled or are they restless and unable to stay settled for long?
  • Are they whining, crying, panting, pacing?
  • Does their abdomen appear to be distended?
  • Would you describe them as getting bony?
  • Are they following you everywhere and seem more needy?
  • Do they no longer go on the couch or the cat tree?
  • Do they need to break their activities into smaller steps, such as jumping up on a chair, then jumping to the counter?
  • Are they leaving their rump area unattended because they can no longer reach when grooming themselves?
  • Do you worry you are hurting them if you pick them up or are they snippy if you touch or move them?
  • Are they seeking warmth or cool more than they used to?
  • Do you feel they are in pain?

R is for Respiration:

R Score

  • Is your pet’s breathing and vocalization all normal?
  • Is your pet breathing calmly and slowly (under 30 breaths per minute at rest)?

  • Are they breathing faster than normal unrelated to exercise and not taking a break, like they do with panting?
  • Are they breathing with increased effort, sucking air in and/or pushing air out?
  • Do they have any discharge from/crusting on their nose?
  • Are they coughing, sneezing, wheezing, snoring louder?
  • If your pet is a cat, are they open mouth breathing (which is NOT normal for a cat)?  

N is for Nervous System:

N Score

  • Do they recognize you?
  • Do they respond when you speak to them, or touch them? 
  • Are they still interested in the goings on outside? Such as packages being delivered/doorbell ringing, or noticing birds and squirrels?
  • Do their senses, personality, and behavior remain the same?

  • Are they deaf, blind, not able to sense their food or treats by smell?
  • Having difficulty chewing or swallowing?
  • Do they walk like they are drunk, do they have a head tilt, or do they walk in circles?
  • Are they vocalizing (barking, meowing) more or less than usual, or has there been a change in how it sounds, sounding hoarse, or have any change in bark or meow?
  • Do they drag their feet or trip?
  • Are they yawning a lot more?
  • Do they tremble or shake now?
  • Have they had any seizures?
  • Are they having any behavioral issues?
  • Are they confused or apathetic, do they seem lost or aimlessly wander around the house/yard, do they get stuck in corners or under furniture or have they wandered out of the yard?

E is for Elimination:


E Score

  • Are they normal with urination and defecation?
  • Can they hold it all day while you are out?
  • Do they go to the bathroom on their usual schedule and there are no changes in their elimination habits?

  • Are they having trouble posturing to urinate or defecate or straining?
  • Are they drinking more and urinating more?
  • Do you notice any foul odor, blood, or color change to their urine?
  • Has your veterinarian suggested or have started giving them under the skin fluids?
  • Are they hovering near the water dish, but you are filling it less often?
  • Do you have to scoop or change the litter more often and are the urine balls larger?
  • Are they not making it outdoors in time, missing the litter box?
  • Are they indiscriminately dropping fecal matter as they walk around or are they messing in their beds, or on themselves?
  • Do they have to wear diapers or belly bands?
  • Are they having loose stool or diarrhea, is there blood, or black/tarry stool?
  • Do they wake you in the night to go out?

Y is for You:

Y Score

You also matter. Your mental, emotional, financial, and physical budget can be injured when you have nothing left to give.

  • Is everything manageable, you have a care plan in place that works for you, and you don’t feel overwhelmed?
  • Do you have support from family or friends?

  • Is there discord about how your pet is doing ?
  • Perhaps work, your relationships, or your bond with your pet is suffering due to your pet’s health?
  • Do you feel comfortable going to work or going on vacation and leaving your pet?
  • Are you worried about your monetary budget?
  • Are you spending a lot of time worrying if you are doing the right thing?
  • Is the physical care of your pet taking a toll on your physical or mental health?
  • Are you too tired to do anything else but help your pet and are you getting enough sleep to function the next day?
  • Are you overwhelmed by the amount of care you need to provide for your pet and feel like you are neglecting other areas of your life?
  • Do you feel like managing their illness is burdensome or taxing? Are you resenting having to care for them?
  • Do you have concerns that you may not understand everything that is going on with your pet and what may happen in the future and is that making you nervous?
  • Do you feel like you can’t leave the house anymore?
  • Are you worried your pet will die alone?
  • Are you experiencing anticipatory grief?

Total: 0

A score of 59 and above suggests everything is probably fine. The situation may need a little bit of adjusting with your pet’s care team.

A score of 49 to 57 necessitates assistance. Schedule a visit to your veterinarian to see what is going on and what can be done. If your pet does not have the budget for veterinary care anymore, an in-home hospice consultation to provide palliative care for your pet may be in order.

A score of 39 to 46 requires intervention. We are done with diagnostics, and/or your pet cannot tolerate more or any medical intervention. You need to schedule an in-home hospice consultation or end-of-life care visit for your pet.

A score of 37 and below tells us we have done all we feel we can and it’s time to provide a compassionate gentle journey with grace and dignity for your pet.

Quality-of-Life Assessment Tools


Assessing Pain:

All Species

Determining Whether It Is Time and Other Quality-of-Life Tools