| Theme |
Dementia of Haemodialysis Elder Patients |
| Title |
The appropriateness and problem of dialysis initiation of demented patients |
| Author |
Seiji Ohira |
Department of Surgery, Kidney Center, Nikko Memorial Hospital |
| Author |
Yasushige Tsuji |
Department of Surgery, Kidney Center, Nikko Memorial Hospital |
| Author |
Noritomo Itami |
Kidney Center, Nikko Memorial Hospital |
| [ Summary ] |
As patients initiating dialysis have been increasing in age, situations in which we must consider the appropriateness of dialysis initiation of demented patients have also increased. Performing the process of informed consent, which is the most fundamental step when any kind of therapy is planned, is difficult to carry however, cooperative substitute decision-making by the medical staff and family members becomes urgently mandatory. Japan as a society has many problems yet to be solved in order to perform this difficult job smoothly, without leaving behind any mental trauma as well as performing it in accordance with law. The new "Adult-guardianship Law" was enacted in April, 2000 in Japan. The concept and its associated principles will help us to define the idea of autonomy in which one should consider his own path to follow in future. Subsequently, one will reach the conclusion that one cannot avoid thinking about what to do in his own serious or terminal stage. |