| [ Summary ] |
For uremic patients, renal replacement therapies, including hemodialysis, peritoneal dialysis and renal transplantation are generally introduced to ameliorate uremic conditions and to extend patients' survival. These therapies may be insufficient or somewhat inappropriate for patients of advanced age. Improvements in patient quality of life (QOL) or simple relief from pain and suffering are deemed more important in cases associated with dementia. Before making a clinical decision on dialysis modalities, it is also essential for the medical staff to recognize the social status of patients and their families, along with their desires. Available support systems should be utilized as far as possible, to provide satisfactory medical assistance. These issues concerning nursing care are reviewed and discussed in relation to a case of an 87-year-old patient who initially rejected, but finally accepted peritoneal dialysis therapy. |