2.50
Hdl Handle:
http://hdl.handle.net/10755/152306
Type:
Presentation
Title:
Improving end-of-life care for elderly dialysis patients
Abstract:
Improving end-of-life care for elderly dialysis patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Brunier, Gillian, MScN, RN, CNeph(C)
P.I. Institution Name:Sunnybrook Health Sciences Centre
Title:Nurse Practitioner Nephrology
[Symposium Presentation] Care for elderly dialysis patients at the end of life is challenging, presenting ethical, legal, medical, and pyschosocial dilemmas. Clinical practice guidelines have been developed in the United Kingdom and the United States to give direction to the nephrology team in providing end-of-life care to patients on dialysis. All these guidelines promote the involvement of palliative care, especially for patients who withdraw from dialysis. We have previously published study results on general outcomes for a cohort of elderly patients starting dialysis. The aim of this project was to examine the effect of palliative care services on the end-of-life care of elderly patients on dialysis. We conducted a retrospective cohort study (2000-2005) of all patients 80 years and older who had started dialysis at our regional dialysis program. Our cohort included 105 patients: 50 percent were women and the median age was 84.5 years (range 80-95 years). Over the study period 59 patients died while still on our program. Of these 59 patients, 27 (46%) had received a palliative care consult. In the palliative consult group, all patients had a do not resuscitate (DNR) order in place, 22 (81%) were prescribed medications for pain in the 24 hours before death, and 19 (70%) withdrew from dialysis before death. Patients received the palliative care consult a median of 6 days (range 1-110 days) before death. An integrative approach to care for elderly dialysis patients at the end of life, drawing on the skills and knowledge of both nephrology and palliative care multi-disciplinary teams, will ensure control of symptoms and a dignified death for these patients. This approach still provides individualized care, thus meeting the guidelines for best practice. Further research is required on how and when best to involve palliative care services for these dialysis patients at the end of life.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving end-of-life care for elderly dialysis patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152306-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving end-of-life care for elderly dialysis patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Brunier, Gillian, MScN, RN, CNeph(C)</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Sunnybrook Health Sciences Centre</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Practitioner Nephrology</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gillian.brunier@sunnybrook.ca</td></tr><tr><td colspan="2" class="item-abstract">[Symposium Presentation] Care for elderly dialysis patients at the end of life is challenging, presenting ethical, legal, medical, and pyschosocial dilemmas. Clinical practice guidelines have been developed in the United Kingdom and the United States to give direction to the nephrology team in providing end-of-life care to patients on dialysis. All these guidelines promote the involvement of palliative care, especially for patients who withdraw from dialysis. We have previously published study results on general outcomes for a cohort of elderly patients starting dialysis. The aim of this project was to examine the effect of palliative care services on the end-of-life care of elderly patients on dialysis. We conducted a retrospective cohort study (2000-2005) of all patients 80 years and older who had started dialysis at our regional dialysis program. Our cohort included 105 patients: 50 percent were women and the median age was 84.5 years (range 80-95 years). Over the study period 59 patients died while still on our program. Of these 59 patients, 27 (46%) had received a palliative care consult. In the palliative consult group, all patients had a do not resuscitate (DNR) order in place, 22 (81%) were prescribed medications for pain in the 24 hours before death, and 19 (70%) withdrew from dialysis before death. Patients received the palliative care consult a median of 6 days (range 1-110 days) before death. An integrative approach to care for elderly dialysis patients at the end of life, drawing on the skills and knowledge of both nephrology and palliative care multi-disciplinary teams, will ensure control of symptoms and a dignified death for these patients. This approach still provides individualized care, thus meeting the guidelines for best practice. Further research is required on how and when best to involve palliative care services for these dialysis patients at the end of life.</td></tr></table>en_GB
dc.date.available2011-10-26T11:31:22Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:31:22Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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