An estimated 70% of U.S. homes have at least one companion animal. From reducing stress to protecting against depression, these animals enhance people’s well-being in many ways. However, the responsibility of caring for them can also have a negative impact on their guardians. People may turn down housing, delay or even refuse necessary medical treatment, or remain in domestic violence situations, all out of concern for their animals and a widespread lack of support systems.

This study explores the issue from the perspective of healthcare and social service providers. In early 2024, researchers recruited a convenience sample of 285 Colorado residents through personal outreach, professional and institutional networks, and social media. Participants completed a 10-minute online survey consisting of both Likert-scale and open-ended items centered around four research questions:

1. How often and in what ways does being a companion animal guardian affect people’s healthcare decisions?
2. How do providers currently support companion animal guardians?
3. What do providers believe about the role of companion animals in healthcare and social services?
4. What resources and training do providers need to better support companion animal guardians?

The researchers then calculated descriptive statistics and analyzed the open-ended responses for thematic trends.

The survey sample was made up of six groups: emergency medical service providers (31%), social service providers (20%), medical students (15%), social work students (14%), staff at nursing care and assisted living facilities (11%), and healthcare providers (9%). Participants ranged in age from 18 to over 65. In all but the emergency medical service provider group, the majority of participants were female. Most participants had companion animals themselves at the time of the survey, and all but a few had lived with at least one companion animal at some point in their life.

There was broad agreement among participants that companion animals affect the decisions that people make when needing healthcare or social services. At least 66% of participants in each group agreed that they complicate the decision-making process for their guardians. For instance, at least once a month, 62% of healthcare providers encountered guardians who delayed treatment, while 50% encountered guardians who refused treatment.

Some of the most common reasons behind these decisions included:

• No-pet policies or pet restrictions prevented guardians from keeping their animal.
• Guardians had no one else to look after their animal while receiving services.
• Remaining with their animal was important to guardians’ well-being.

Participants also reported that guardians experienced greater stress while receiving services because they were worried about their animal, and would sometimes leave care early as a result.

To help address these barriers, participants turned to informal networks like guardians’ friends, family, and neighbors, as well as more formal services from animal control, animal shelters, humane societies, law enforcement agencies, and boarding facilities.

At the same time, there were clear resource and training gaps identified. For example, 85% of healthcare providers and 100% of medical students said they received little to no training about animal-related resources for patients. Popular requested resources included:

• Help with temporary animal care;
• A database of available resources;
• Training and protocols around addressing companion animal-related concerns in treatment plans; and
• Access to low-cost veterinary care and other pet care resources.

Finally, there was notable variation across services. In most groups, over 70% of participants agreed that companion animals contributed to service delays or refusals. But for social service providers, agreement was much lower — just under 50% believed this was true. Similarly, while emergency medical service providers integrated companion animals into treatment planning at least weekly in close to 20% of cases, only 13% of social service providers did the same. Moreover, 54% of healthcare providers received patient requests to include companion animals in treatment plans on a weekly basis, compared to just 9% of social service providers and 8% of emergency medical service providers. The reasons for these differences warrant further investigation.

Based on these findings, the authors outline a number of recommendations. Some key suggestions include:

• Emergency medical services: Develop procedures for addressing companion animals present during emergency calls, such as coordinating with animal control.
• Healthcare: Screen for companion animal concerns at intake, including questions about care arrangements during treatment.
• Social services: Create and maintain a database of local resources for temporary animal care, veterinary assistance, and pet-friendly housing options.
• Long-term care facilities: Create policies for pet-friendly spaces, as well as visitation and residence options for companion animals.
• Medical and social work education: Incorporate content on the human-animal bond and the impact of companion animals on healthcare decisions into curricula.

This survey involved a small, non-randomized sample of participants from a single U.S. state, which may limit the generalizability of the findings, as well as bias them towards people with a particular interest in the issue. Despite these limitations, however, the study highlights how widespread companion animal concerns are and the degree to which they impact guardians’ use of healthcare and social services. Considering companion animals within these systems will not only contribute to more efficient service provision and more holistic support for guardians, but will also ensure the animals themselves are no longer left behind.