Dialysis and dementia

Discussion in 'ARCHIVE FORUM: Support discussions' started by bianca, Jun 18, 2010.

  1. bianca

    bianca Registered User

    Jun 11, 2010
    7
    Hi. My dad has just been admitted to hospital with acute kidney failure. he has vascular dementia. He is far from happy there and is agitated about having a drip/catheter in. if her were left alone he would pull them out. The hospital say that they are going to carry out an emergency dialysis (he has not needed this before) in the early hours of the morning: I think they may have to sedate him for this. They do not know if this will be a one off or not. Does any one have experience of treating someone who now has quite advanced dementia with dialysis? I do not know whether dad would tolerate it and query how it would effect his quality of life. I am worried that if he does not have too long left, we should make it as pleasant and comfortable as possilbe. Dialysis will not provide a cure just prolong matters.i don't want to play god with dad's life but I know if he were well he would not want to prolong things for the sake of it.
     
  2. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,124
    Kent
    Hello Bianca

    This sounds a really difficult situation. Has anyone discussed it with you? I would ask to see the doctor in charge and ask all your questions. He is the only one who can really tell you what you need to know.
    I have no recall of anyone posting on TP about dementia and dialysis
     
  3. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    My thought would be that it would be unlikely that you would be able to block the treatment. This is because it would be viewed as life saving, but not invasive. So it is not like issuing instruction of "do not resuscitate" when someone is close to death in any case. Usually life-prolonging treatment is easier to block the more distressing it is to the patient, and the closer they are to inevitable death in any case. An example might be, fitting someone with a feeding tube when they are in a very advanced state of dementia and it is thought they are likely to die shortly in any case (note that people almost always die from secondary causes - it is very rare for dementia to be a direct cause of death)

    On the other hand, if your dad is still capable of clearly stating his wish not to be treated, he does of course retain the right to refuse any and all such treatment the same as anyone else.
     
  4. Sandy

    Sandy Registered User

    Mar 23, 2005
    6,847
    Hi bianca,

    It all really hinges on whether or not your father has the mental capacity to refuse/accept treatment. Has he been assessed to see if this is the case or not?

    If he lacks the capacity, then a Best Interests meeting should be called to determine if the treatment is appropriate.

    You and your mother would be part of that process. Do either of you hold any type of power of attorney for your father? It's not required of course, but a Lasting Power of Attorney for Welfare matters can be helpful when you really want the authorities to take note of your opinions.

    Here is some information from the Alzheimer's Society about consent and mental capacity:

    http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200168&documentID=484

    http://www.alzheimers.org.uk/factsheet/460

    This is a link to a rather large but very clear PDF on the Best Interests process:

    http://www.pmldnetwork.org/resources/bps_best_interests_guide.pdf

    Take care,
     
  5. allylee

    allylee Registered User

    Feb 28, 2005
    180
    west mids
    Hi Bianca, Im a senior sister in a renal dialysis unit in the West Mids. Dialysis is an aggressive therapy that takes it out of the patients physically and emotionally and is certainly no soft option for an otherwise fittish person, nevermind someone with dementia.
    I am suprised that as a family you havent been consulted about treatment opotions for your dad. In my own Trust , all options are discussed with the family including the no dialysis option.

    As a speciality we are very "pro" family involvement and to withdrawing and witholding treatment in certain circumstances.
    Speak to dads consultant or the renal unit staff...dialysis requires a lot of co operation from the patient, invasive procedures, numerous blood tests and a fluid and diet restriction...its a tough regime.Good luck and keep us posted xx
     
  6. BeverleyY

    BeverleyY Registered User

    Jan 29, 2008
    716
    Ashford, Kent
    This must be awful for you.

    My Mum (who didn't have dementia) had dialysis for the last year and a half of her life.

    It drained her physically and emotionally at times, but also gave her a zing in her step the day after dialysis. I used to say she'd been 'plugged in' for an energy zap.

    Last year my GP told me that Dad (who does have dementia) is now also showing early signs of renal failure.

    I absolutely know that my Dad would not be able to cope with dialysis and it's something I personally would try to persuade them not to do.

    My Dad would be climbing the walls with anger and upset if he could see the person he has become and would be very dissappointed at any decision to prolong his life in these circumstances.

    Best wishes.

    Beverley x
     

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