If you are reading this, you are probably a kidney patient or a family member affected by kidney disease, and treatment is either under way or being discussed. An important part of ongoing discussions with your care providers is a frank talk about the benefits and burdens of treatment options and what is most important to you on this journey. This advance care planning is discussed below.
Whether you have chosen dialysis or not, you certainly want to be comfortable and supported. Palliative care, centered on your wishes, can be an important addition to the good care you are already getting. Skilled specialists in this new field can address your need for control of symptoms such as pain, fatigue, nausea and vomiting, a decline in mental functioning, and depression. Palliative care doctors, nurses and social workers can work with your nephrologist or dialysis provider to ensure your well being, and that of your family members. Ask your care provider if a palliative care consultation can be added to your plan of care.
More information on palliative care:
Hospices provide specialized palliative care for persons facing life’s end and support for their families. Hospice can become involved when your physician believes that your life expectancy is six months or less, and you agree that treatment for cure is no longer helpful. This does not mean there is nothing more to be done. State-of-the-art hospice care adds a new level of comfort and peace of mind so that every day can be lived to the fullest.
Physicians, nurses, social workers, aides, therapists and spiritual care providers are part of the hospice team that provides care where you are, be it at home or in a long-term care facility. Short-term inpatient hospice care is available if symptoms need better control. Medicare, Medicaid and almost every insurance plan covers hospice care for the terminal diagnosis. Since many kidney patients have other serious illnesses beside kidney failure, they may receive hospice care for the first diagnosis without affecting their dialysis coverage. Very few hospices will accept dialysis patients whose sole diagnosis is kidney failure because hospice programs cannot bear the dialysis costs. Those with end-stage kidney disease who have not started dialysis, or who choose to stop it, are very appropriate for hospice care.