This article discusses the challenges elderly patients face with dialysis as their kidney function declines. It notes that patients over age 85 who start dialysis only have a life expectancy of 2 years, while those between ages 75-79 have a life expectancy of 3 years. Dialysis can lead to physical decline, frailty, falls, and increased risk of illness and death for elderly patients. The article encourages patients to consider their current quality of life, health issues, and support system when deciding whether to start or continue dialysis. It emphasizes dialysis is a life-sustaining treatment that can be declined.

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?

5. Hemodialysis uses an
artificial kidney machine
to remove toxins and
extra fluid from the blood.

7. Peritoneal dialysis cleans
and removes fluid from
the blood through the
natural membrane in the
abdomen.

8.  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

9.  pain
 physical disability
 poor appetite
 poor energy and functioning
 depression
 cognitive impairment (Dannelke)
 Frailty & falls

10.  Loss of bone density
 Weakness
 Weight Loss
 Functional decline

11.  high risk for increased
illnesses
 Increased mortality
 increased hospitalization &
nursing home placement.

12.  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?

13.  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
don’t place dialysis in that category.
 Dialysis is a big deal.
 It’s a life sustaining treatment.
 It’s a life altering treatment

14.  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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