Tyneside Kidney Patients Association
Sister Therese Wood gave us a very good talk illustrated from her experience. Her work is now called Active Supportive Care instead of Conservative Care.
Therese explained how she looks after kidney patients who either don’t want renal replacement therapy such as dialysis or a transplant or are unable to cope with such treatments. Currently this involves caring for 95 patients in a large area from Berwick on Tweed to Durham.
Therese works with patients in their own home. This involves getting blood pressure and haemoglobin levels as good as possible. Often this enables patients to lead a good life even though their kidney function is 5% or less.
Her work involves end of life care and is guided by the principle that “No patient should die in pain.” This includes applying the Liverpool Care Pathways which make provision for all the needs of patients in the last 48 hours of life.
Conservative management refers to treatment without having dialysis or a transplant. It is sometimes called Supportive Care. Some patients choose, after consultation with their kidney team, not to have dialysis as it may not improve survival to any great extent.
What is involved?
The aim of conservative management is to maintain a good quality of life by prolonging kidney function and controlling symptoms. It gives support to patients, their families, and carers. Good planning and communication can help avoid inappropriate hospital admissions.
Who is involved?
There will be a number of health care professionals to ensure that you are cared for in a way that suits you and meets your needs.
The aim of conservative management is:
Preventing and treating any symptoms
Protecting and maintaining remaining kidney function
Planning for the future
Planning for the future
This means thinking about how and where you want to be cared for when you become less well and at the end of your life. This might be your own home or a hospice.
Can I make an advance decision about treatment I do not want?
In the United Kingdom you can decide what treatment you do not want if, in the future, you are unable to make decisions yourself. Ask your healthcare team for more information about doing this.
How long will I live?
This varies for each individual. There are many things that affect how long you will live. Your healthcare team will be able to discuss this with you in more detail and will explain the things that can affect this.
Can I change my mind once I have decided not to have dialysis?
Yes. Your healthcare team will support you in any decision you make. However, starting dialysis in an emergency is not as easy as starting it in a planned way.