| Theme | Role of home support for elderly dialysis patients -- nursing and care giving | |
|---|---|---|
| Title | Present condition and subject of support in elderly patient's home peritoneal dialysis | |
| Publish Date | 2013/03 | |
| Author | Michiko Maezono | Nursing Department, Tokorozawa Kidney Clinic |
| Author | Chieko Seki | Nursing Department, Tokorozawa Kidney Clinic |
| Author | Takehito Kobayashi | Department of General Internal Medicine, Saitama Medical University |
| Author | Hidetomo Nakamoto | Department of General Internal Medicine, Saitama Medical University |
| [ Summary ] | In recent years, elderly patients with end stage renal failure (ESRD) have been successfully treated with peritoneal dialysis (PD). PD is a suitable medical therapy because it enables us to maintain good residual renal function (RRF) and prevent severe heart failure. In Japan, PD remains the principal modality for in home dialysis for the elderly although PD patients account for only 3.2 % (n=9,626) of the overall dialysis patient population. However elderly ESRD patients, sometimes experience difficulties in the continuation of PD therapy. Problems may arise due to the development of dementia as well as declines in muscular strength, vigor, and overall physical strength of patients. In spite of these difficulties, some local dialysis centers have tried to maintain and manage elderly PD patients at home by utilizing diverse social resources, in addition to obtaining the cooperation of caregivers such as family members. In Japan, in home support for elderly PD patients is available in several special forms. These consist of utilization of visiting nurse care or home-visit nursing care services. Information concerning renal failure and education on home-care support providers and welfare service facility staff members is also provided. In addition, patient support is given through use of social community support systems, such as a care support institutions and day care centers. Modification of PD therapy through such means as use of automated PD and hemodialysis, as well as PD combination therapy must also be properly implemented. The organization of treatment teams, including physicians, nurses, social workers and dietitians, as well as the construction of centralized patient information management systems are all important for treatment of elderly patients who require dialysis therapy. It is important to consider the best support system in relation to individual patient's situations and needs. |
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