DIALYSIS & THE ELDERLY Something to Think About By, Cherise Gabir, RN, CCM, FAACM
Transcript
1. Something to Think About By, Cherise Gabir, RN, CCM,
FAACM
2. As a Registered Nurse for over 20 years and Certified Case
Manager, I see elderly patients cycle through the various levels of
care, as they receive their dialysis treatments and endure the
debilitating effects of their multiple illnesses, including
diabetes, heart failure, hypertension, strokes, and dementia.
3. What is Dialysis?
4. Hemodialysis uses an artificial kidney machine to remove
toxins and extra fluid from the blood.
5. Peritoneal dialysis cleans and removes fluid from the blood
through the natural membrane in the abdomen.
6. patients who start dialysis over age 85 have a 2 year life
expectancy. Those who start between ages 75 to 79 have only a 3
year life expectancy. patients age 75 and older are the fastest
growing group of dialysis patients
7. pain physical disability poor appetite poor energy and
functioning depression cognitive impairment (Dannelke) Frailty
& falls
8. Loss of bone density Weakness Weight Loss Functional
decline
9. high risk for increased illnesses Increased mortality
increased hospitalization & nursing home placement.
10. What is my quality of life now? Do I have multiple health
problems? Do I have someone in my life who can care for me if I
need it? Have I discussed my prognosis with my doctor? How
important is independent functioning to me?
11. Our elderly family members may make it clear that they do
not wish to be hooked up to any life support devices; however, many
people dont place dialysis in that category. Dialysis is a big
deal. Its a life sustaining treatment. Its a life altering
treatment
12. Consider your current level of functioning Decide how you
wish to spend the last years of your life Consider if and how your
treatments will affect the lives of your loved ones Realize that
dialysis is an option that can be declined Discuss your options and
the implications with your doctor and your loved ones
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L.L., et. al. "EPEC Handbook, Elements & Models of End-of-Life
Care." 1999. AMA- ASSN.org. 15 Feb. 2015 . Graham, Judith.
"Dialysis Raises Hard Questions For Older Patients." 4 Dec. 2003.
15 Feb. 2015. Jassal, S. and Watson, D. "Dialysis Late In Life:
Benefit or burden." Nov 2009. CJASN.org. 25 April 2015 . Jecker,
Nanacy. "Medical Futility." n.d. University of Washington School of
Medicine. 13 Feb. 2015 . Keown, John. "Euthanasia, A Quality of
Life Choice_benheis.pdf." n.d. 13 Feb. 2015. MacReady, Norra.
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