| Theme | Degree of Dialysis Nursing Care for Old-old Population is Growing Rapidly | |
|---|---|---|
| Title | Dialysis therapy for old-old patients Initiation, non-initiation and discontinuation | |
| Publish Date | 2000/10 | |
| Author | Seiji Ohira | Department of Surgery, Kidney Center, Nikko Memorial Hospital |
| [ Summary ] | Initiation, non-initiation and discontinuation of dialysis therapy should be determined with respect for the patient's will (right of self-determination). It is true that old and old-old people are apt to show multiple comorbidities and dysfunction of vital organs, but there exist large individual differences. Performing dialysis for the senile is often accompanied by difficulties, however, one cannot judge only by calendar-age whether or not the patient should undergo dialysis therapy. One has the right to live and also the right to die. But the latter sometimes becomes the duty to die. "The duty to die" if it comes from self-determination, it must be autonomous and not be forced. The senile should be unhesitantly referred to dialysis therapy if there are proper medical indications, his/her own acceptance and expectation of improving ADL and QOL. The existence of an advance directive is hoped for, and the number of persons preparing them will increase in the near future. But until that time, we will be unable to shirk situations necessitating surrogate decisions. |
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