- Among people on dialysis, only 49% had advance directives, finds a study by doctors from Mayo Clinic.
- Only 10.6% mentioned dialysis and only 3% mentioned dialysis management in advance directives.
- Advance directives should be prepared in consultations with the individual, loved one and the doctor.
There
is increased awareness about preparing advanced directives which are documents
that specify a patient's need for care and preference for the line of care, in
the event of a situation when the patient may be unable to make conscious
decisions. A study that analyzed the directives of advanced care patients, only
a small percentage included directives on managing dialysis.
The
study was published in the Journal
Clinical Journal of the American Society of Nephrology (CJASN) highlights
issues concerning advanced directives, where preparing an advanced directive
should detail more about the end of care that should be received.
Preparing Advance Directives
Analyzing Advance Directives
Dr. Molly Feely and colleagues from the Mayo Clinic analyzed actual directives from patients who were undergoing dialysis. The medical records of 808 patients who received in -hospital dialysis between January 2007 and January 2012 were studied.
It was found that among 808 patients -
- 49% had advance directives
- only 10.6% mentioned dialysis
- only 3% mentioned dialysis management specifically at the end of life
- 44.2% mentioned cardiopulmonary resuscitation
- 37.1% mentioned mechanical ventilation
- 34.3% mentioned artificial nutrition and hydration
- 43.4% mentioned pain management
- 10.6% mentioned dialysis
Dr. Feely added, "Unfortunately, our study revealed that the advance directives of our dialysis patients failed to address how our patients wanted to manage their dialysis at the end of life, an issue of critical importance to this population. Future research needs to be much more sophisticated in how we measure the success of advance care planning and advance directive execution such that we assure that we are actually improving patient outcomes."
Dr. Sara Combs from The University of Colorado stated along with this study that The United States had the financial capacity to provide dialysis for nearly every citizen, even if they did not have the financial resources to fund their dialysis procedure on their own.
Dialysis is a life-sustaining procedure and patients' needs to be informed about the benefits associated with this procedure. The researchers conclude that stopping dialysis or not taking up dialysis are also viable options that may be considered.
Dialysis
Dialysis is a procedure in which some of the functions of the kidney are performed by a dialysis machine. It is performed in conditions where the kidney is unable to perform its functions well, resulting in a toxic build-up of waste.
Dialysis aids in keeping your body in balance by
- Removing extra water, waste and salt
- Maintaining levels of sodium, potassium and calcium
- Aids in controlling blood pressure
It is important for the patient to understand the need for dialysis and to make an informed mention in the advance directives, to better manage end of life care.
References:
- Dialysis - (https://www.kidney.org/atoz/content/dialysisinfo)
Citations
Please use one of the following formats to cite this article in your essay, paper or report:
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APA
Amrita Surendranath. (2016, December 30). Dialysis Management Rarely Mentioned in Advance Directives. Medindia. Retrieved on Aug 15, 2022 from https://www.medindia.net/news/healthinfocus/dialysis-management-rarely-mentioned-in-advance-directives-166604-1.htm.
-
MLA
Amrita Surendranath. "Dialysis Management Rarely Mentioned in Advance Directives". Medindia. Aug 15, 2022. <https://www.medindia.net/news/healthinfocus/dialysis-management-rarely-mentioned-in-advance-directives-166604-1.htm>.
Chicago
Amrita Surendranath. "Dialysis Management Rarely Mentioned in Advance Directives". Medindia. https://www.medindia.net/news/healthinfocus/dialysis-management-rarely-mentioned-in-advance-directives-166604-1.htm. (accessed Aug 15, 2022).
Harvard
Amrita Surendranath. 2021. Dialysis Management Rarely Mentioned in Advance Directives. Medindia, viewed Aug 15, 2022, https://www.medindia.net/news/healthinfocus/dialysis-management-rarely-mentioned-in-advance-directives-166604-1.htm.