Dialysis typically buys a person some time. But it rules their life—and possibly yours. It requires strict adherence to the schedule. Also, severe food restrictions. Your relative’s energy level will fluctuate. That makes planning for other activities difficult. There is an increased chance of infection because of the access port for dialysis. And there are side effects: Itchy skin, trouble sleeping, headaches, and dizziness. Cramps, nausea, weight loss, and fragile bones are not uncommon.
Unless your relative is doing home dialysis, they will need transportation to and from the center. A typical schedule involves two to three sessions a week. A session lasts about four hours.
One option to consider is managing the disease without dialysis. Admittedly, this may shorten length of life. But even patients on dialysis often decide to stop the treatment when the difficulties outweigh the benefits.
People who say “no” to dialysis from the beginning place a high value on quality of life. They prefer the thought of living on their own terms for eight months to living fifteen to twenty-four months with the rigors of dialysis.
People who receive the least benefits from dialysis are
- persons age 80 or older. Only 1:3 is alive two years into dialysis.
- persons with other serious conditions, such as heart disease or diabetes. Two years into dialysis, only 2:3 are still living. This goes down to 1:3 if they have two serious illnesses.
- persons with dementia. They have trouble following the restrictions. The procedure can also be confusing or scary to them.
Deciding against dialysis does not mean no treatment. Your relative’s doctor will prescribe medications for blood pressure and fluid buildup. And to address fatigue. All of these treatments support easier walking and breathing. A better daily experience.
Deciding against dialysis is very personal. Ask the doctor to talk about your relative’s best- and worst-case scenarios with and without dialysis. A care manager can also help your loved one weigh the options.