The Japanese Journal of Clinical Dialysis Vol.32 No.11(1)

Theme Support for dialysis patients by using social resources
Title The status quo of dialysis patients who require sufficient care
Publish Date 2016/10
Author Takashi Harada Nagasaki Kidney Hospital
Author Osamu Sasaki Nagasaki Kidney Hospital
Author Hiroshi Ichinose Nagasaki Kidney Hospital
Author Kenji Sawase Nagasaki Kidney Hospital
Author Junichiro Hashiguchi Nagasaki Kidney Clinic
Author Yuko Maruyama Nagasaki Kidney Hospital
Author Satoshi Funakoshi Nagasaki Kidney Hospital
[ Summary ] Elderly dialysis patients experience decreased daily activity, which is worsened when complications like diabetes and dementia are present. The level of care needed for elderly dialysis patients who require hospitalization is particularly high. The factors that cause elderly dialysis patients to require additional care include dementia, cerebrovascular disorders, bone fracture, lower limb amputation, frailty, sarcopenia, poor nutrition, poor medication adherence, mental problems, lack of suitable transportation to and from the hospital, poor living environment, and disadvantaged economic background. Patients who need care prefer to use a social welfare health insurance system that enables local treatment based on multidisciplinary intervention. With regard to medical treatment (end-stage treatment) for dialysis patients in the final stages of life (at the terminal stage), the Japanese Society for Dialysis Therapy has presented guidelines for the shared decision-making process of forgoing hemodialysis to contend with the maintenance of blood dialysis. Conformity to those guidelines is recommended.
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