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1 Coservative treatmet: Choosig ot to start dialysis

2 T H E K I D N E Y F O U N D A T I O N O F C A N A D A 1 Coservative treatmet: Choosig ot to start dialysis You have the right to make your ow choices about how you are treated for kidey failure. That meas you ca choose ot to start dialysis. It is importat for you to have all the iformatio you eed to make this decisio. Oce your kideys have reached the poit where you would ormally eed dialysis, it is importat to kow that if you choose ot to start, your health will cotiue to fail ad you will evetually die. This pamphlet addresses cocers you or your family may have. It will help you get ready to talk about this choice with your healthcare team. What is coservative treatmet? If you choose ot to start dialysis, you are choosig what is kow as coservative treatmet. Excellet medical care is still available if you choose this type of treatmet. Coservative treatmet meas usig medicatios ad diet to maximize your comfort, ad help with ay symptoms you may have. Machies such as respirators ad dialysis machies will ot be used.

3 2 Why would I choose ot to start dialysis? Ofte people have may other health complicatios ad dialysis may ot help treat these other problems. Dialysis is a treatmet meat to improve your life, ot cause further harm ad sufferig. This is a persoal decisio based o the quality of life you wish to have. It is importat for you to make this choice for the right reasos. Your healthcare team ca help you rule out ay factors like depressio, stress or other medical issues that could be chaged to improve your quality of life. Is choosig ot to start dialysis cosidered suicide? NO. Choosig ot to start dialysis is like ay other choice people make whe they decide whether or ot they wat a medical procedure. What makes this decisio difficult is that without dialysis, your health will deteriorate ad you will evetually die. Caadia healthcare stadards accept the decisio to ot start dialysis as a treatmet choice. You are ecouraged to speak with your healthcare team ad your religious advisor if you are cocered your faith or culture has a differet view.

4 3 What will happe to me if I choose o dialysis? Each perso reacts differetly depedig o their medical coditios. If you choose ot to dialyze, you will eed to talk to your doctor about the kid of care you wat as your kideys fail ad you begi the dyig process. This is called palliative or comfort care. Sometimes, people wat to be i hospital durig this time. Others may wat to make plas to have help ad support so they ca die at home. Depedig o where you live, special support services may be available for this type of home care. You will still have a healthcare team lookig after you. How do I talk about this choice with my family ad frieds? The decisio to ot start dialysis ca be a very difficult ad paiful choice to share. It is importat to talk about this decisio with your loved oes. You may eed to help them uderstad why you made this decisio. If you get very sick, your family may have to make treatmet decisios for you. For that reaso, you eed to share your feeligs with them. Your real social worker ad other members of your healthcare team ca help you prepare for this difficult coversatio.

5 4 What kid of support ca I get? If you choose ot to start dialysis, you should talk with your healthcare team about what kid of help is available i the hospital or i your home commuity. Every commuity is differet ad every patiet s eeds are differet. Will my doctor ad healthcare team help me decide? Yes. Your doctor must first recommed that dialysis is a treatmet optio. Your doctor may offer a opiio if dialysis will actually improve your quality of life. The fial decisio about startig is yours. What if I m ot sure about dialysis -- ca I try it out first? Yes. You may wat to ask your doctor about a trial of dialysis to see if ad how your quality of life will improve. If, after this period, you feel that dialysis gives you a acceptable quality of life, you may wish to cotiue treatmets. If you feel that dialysis gives little beefit, you may wish to stop dialysis ad accept coservative treatmet ad palliative care.

6 5 What else do I eed to have i place? Whether you choose dialysis or ot, you might wat to have your Will, Power of Attorey (persoal care ad fiaces), Advace Directives (future healthcare wishes) ad fueral arragemets i place. You may also wat to talk to your family about your wishes regardig orga ad tissue doatio. You may wat to speak with your real social worker about available commuity resources. Questios to ask your healthcare team: Do you thik that dialysis will improve my quality of life? Ca I have a short trial of dialysis? How will I feel if I choose ot to start dialysis? Will my healthcare team still look after me? How log will I live? Ca I choose where I die? What kid of food ad drik ca I have? If I chage my mid, what should I do? What ca be doe if I have ay pai or discomfort? Who will be there to help support my family ad me?

7 6 Feel free to add your ow questios ad brig this list with you. Your healthcare team cares about you ad your family. Please discuss ay of these questios with them. This brochure is a collaborative effort of: - The Caadia Associatio of Nephrology Nurses ad Techologists (CANNT) - The Caadia Associatio of Nephrology Social Workers (CANSW) - The Caadia Society of Nephrology (CSN) - The Kidey Foudatio of Caada

8 T h e K i d ey Fo u d a t i o OUR VISION Kidey health, ad improved lives for all people affected by kidey disease. OUR MISSION The Kidey Foudatio of Caada is the atioal voluteer orgaizatio committed to reducig the burde of kidey disease through: fudig ad stimulatig iovative research; providig educatio ad support; promotig access to high quality healthcare; ad icreasig public awareess ad commitmet to advacig kidey health ad orga doatio. For further iformatio, or if you wish to help us i our efforts, please cotact The Kidey Foudatio of Caada office i your area. You ca also visit our Web site at This material is available i accessible formats upo request by cotactig or callig R E F. N O. : B R

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