By E. Joanna Chambers, Edwina Brown, Michael Germain
This publication offers a complete, evidence-based review of supportive take care of the nephrology sufferer. a global staff of members emphasize the continuum of palliative care from the time of analysis via to end-of-life care and the problems surrounding withdrawal of dialysis. The booklet addresses the mental effect of the ailment, the significance of concerning the sufferer in making judgements approximately their care, moral concerns, the position of the kinfolk and the multidisciplinary team.This publication can be of specific curiosity to palliative medication and discomfort experts; nephrologists; who more and more want to know extra approximately palliative care; nurse practitioners; dialysis nurses, social staff, dieticians, and psychiatric specialists.
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Additional resources for Supportive Care for the Renal Patient (Supportive Care)
Example text
314: 209–13. 17. P. (1996). The need and demand for renal replacement therapy in ethnic minorities in England. J. Epidemiol. Community Health, 50: 334–9. 18. United States Renal Data System (USRDS) (2002). org 19. H. (1994). Trends in the incidence of end-stage renal failure due to hypertension and vascular disease in Australia, 1972–1991. Aust. Z. J. , 24: 696–700. 20. , et al. (1996). Elderly patients on dialysis: epidemiology of an epidemic. Nephrol. Dial. , 11(S9): 26–30. 21. , Schneider, P.
When the decision to stop dialysis and go home was taken, the palliative care nurse who had known him for the last year was able to liaise and set up the necessary services to enable this to happen rapidly. Ethical analysis JJ’s dialysis-related amyloidosis, uraemic pruritus, premature atherosclerosis, and resultant depression are all tragic markers of our inadequacies in managing dialysis patients in previous decades. JJ ‘experienced unpleasant symptoms for many years and severe pain from many sources in the last year’.
One of the fortunate aspects of this case is that our thinking with regard to withdrawal from dialysis has progressed. When JJ started dialysis, decisions to stop dialysis were problematic. Now we have an understanding of the ethical and legal principles that should govern a decision to stop dialysis. Ethically and legally, patients with decision-making capacity have a right to accept or refuse life-sustaining treatment such as dialysis. In cases where patients request to stop dialysis, nephrologists have found it helpful to consider a number of issues in responding to patients’ requests (see the Introduction).