Palliative Care in End-Stage Renal Disease

Betty R. Ferrell, PhD, RN

Disclosures

December 04, 2019

Karen, a 77-year-old retired art history professor, has progressive renal disease and has been on dialysis for 2 years. For the first 18 months she was able to maintain an acceptable quality of life, but the past 6 months have been fraught with problems, including diminished function requiring a move to assisted living, pain, decreased cognitive function, and worsening comorbidities including heart disease and diabetes. Karen is basically alone. Her husband died 3 years ago, and although she has two sons, both live abroad, employed in the tech industry. Her closest relatives are three grandchildren living in surrounding states. Karen has had two recent hospitalizations for infections. This week at the dialysis center, Karen tells the social worker that she would like to discontinue dialysis, and she knows this means she will die soon. Karen also shares that one of her friends in the assisted-living center recently died with hospice care and she was so impressed with the care her friend received.

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