My father is 81 years old and was active, passing urine before he got to know that his creative level had reached to 9.2 . He has this issue in the past and was controlling it with medicine to keep it around 3.
As doctor advised and we started dialysis but after 2 dialysis he is very fragile. Now he cant walk , talk and passing urine/ stools etc in his cloths.
This all has been changed in last 2 weeks where he was a relatively active to in really bad shape.
My question to you is did we made mistake in starting dialysis at his age. Can we stop it? Can he still have life rather active instead of bed ridden as he is now
Pls advice urgently as I am really concerned
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KCRG
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This is just my opinion, at 80 I wouldn’t consider doing dialysis, maybe I’m a little naive at age 41 but the body at age 80 struggles to withstand the rigors of dialysis, from what I’ve read anyway. If I live to be 80, and need to make that decision, I’d just consider other treatment options .
Dave... you are correct...you are naïve. My father in law lived to be 94 with CKD. His brother in law lived to be 88 on dialysis. And the only other option when dialysis is recommended is hospice.
Thx Bassetmommer, may I ask did you father and FIL had initial issues when dialysis started like vomiting , lack of appetite, slight fever, cold etc? My father is facing these issues and not too convinced with doctor response. Before I look around for options , I thought of checking with you
Not to my knowledge did Uncle R have issues. Matter of fact, I did not even know he was on dialysis when I first met him. He is my husband's Uncle. Your Father's issues are something you should be very concerned about and I would push you to advocate for him to find out why he is having such a sever reaction. Has any one checked his blood for infection or sepsis?
I would also chat with your Dad and have a frank discussion about what he wants.
No I haven’t. Most of us here talk about things we haven’t experienced. But there’s some peer reviewed literature backing what I’ve said. And why do I get the feeling you’re attacking me??
I'm sorry you're feeling attacked. Never my intention.
Just thinking about your reply. It's like asking others about their MacBook experience and someone replying no experience but here's why I will never use it.
I appreciate your POV though.
Your comment " most of us here talk about things we haven't experienced" isn't true IMHO. I see most responses from those with knowledge and/or experience.
These are questions none of us can answer for you. But I would check with the doctor to see what they recommend. If they recommended dialysis, he must have had levels where he was becoming toxic. The fact that he is in such bad shape now, I would want a consultation with the doctor to see if what options there might be. The fact that he is incontinent might have something more to do with a cognitive issue. Talk to the doctor. Let us know what you find out.
I am 79 and at stage 3b. If it is needed will do dialysis. Maybe age makes a difference in opinion. Possibly also some who are 80 may not opt for it?
The decision on treatment belongs to your father, unless he has a Durable Medical Power of Attorney. The person then named would be the legal decision-maker. Also, if he has an Advance Directive he may have already stated his treatment preferences.
For those who choose not to do dialysis, the physician will suggest palliative care.
A word to the wise to all, regardless of age, prepare those two documents. You can always make changes later if you choose to do so.
It should be noted that palliative care differs from Hospice. Palliative care is for those who wish to continue dialysis but need help with other things I.e. pain control, household chores, counseling etc. Palliative care can provide many resources and be very beneficial for those who are elderly but want to remain in their home.
Hospice care is for those who wish to stop dialysis and remain in home, comfortably until death.
Durable medical POA and an Advance Directive are essentials for those on dialysis IMHO
A lot has been written on this topic. I think dialysis past a certain age is a "double-edge sword". Damned if you do; damned if you don't. A creatine of 9.2 for an 81 year old man sounds pretty high and perhaps dialysis was necessary to keep him alive, i.e. perhaps his potassium was dangerously high or his fluid retention was becoming a problem. Perhaps his symptoms are something he would have experienced anyways. I would discuss this with his nephrologist and see if conservative care makes more sense. I would think you (and he) would want to make his final days as pleasant as possible. I don't think dialysis, even at an elderly age, would make someone not be able to walk or talk or poop his pants (did he have a stroke?).
"THURSDAY, March 17, 2016 (HealthDay News) -- Dialysis does not significantly improve survival for elderly kidney failure patients, a new study indicates.
"The findings suggest that conservative care may be a reasonable option for some kidney failure patients over 80.
"The researchers don't say that dialysis treatment should not be given to anybody older than 80 or with severe co-occurring conditions. "But we show that the treatment is on average of little advantage regarding survival," said study co-leader Dr. Wouter Verberne of St. Antonius Hospital in Nieuwegein, the Netherlands."
My neighbor was 85 and got tired of dialysis and wanted to live his last year without dialysis. He went out on his terms and said he would have not done dialysis when he hit his 80s if he had to do it all over again. He passed away a couple years ago. Great man and veteran.
This must be so heartbreaking for you. There are several things that can impact his strength his fatigue and his digestive system. I highly suggest having a discussion with his nephrologist ASAP. The clinic staff may be trying to remove too much fluid during treatments. It may help to allow your father to *not* have his target weight challenged and allow a 1/2kilo to remain on board as a buffer to avoid under target weight complications such as headaches, nausea, vomiting, diarrhea, weakness, fatigue.
If he is using binders with meals these can for some people cause digestive upset so bring this to attention of doctor and dietitian as they may be able to adjust dosage or change binders.
How is his hemoglobin levels and iron levels? These work hand in hand and often need adjusted. Anemia can cause (in severe cases) cognitive issues, fatigue, weakness, among other issues. If he is anemic or his iron stores/Tsats are low they may be giving him I.V. iron which can also cause diarrhea and/or vomiting for some. They could administer lower doses over a longer period of time to reduce any unwanted side effects.
Lastly dialysis process itself removes protein so it's important to try to replace this. Ask dietitian about his albumin levels which indicate his nutritional levels. Ideally it should be at 4.0 or above. If it's lower you may want to discuss options for supplements.
Now we know dialysis reduces oxygen saturation by as much as 27%, so it may be very beneficial for staff to administer oxygen to your father during treatment to assist keeping proper oxygen levels to brain.
It's a lot to grasp and think about for your loved one. Don't forget it's tough to sit in the chair for so long. If he had any sciatica or back issues the chair time could exacerbate them. Pillows, seat cushions may relieve.
Make a list of his and your concerns by priority and meet in person with doctor to address them. They shouldn't be tackled all at once but one by one. This should be helpful. Take notes ask for clarification on anything you or your father don't understand.
As Mr. Kidney advised getting a durable medical power of attorney and an Advance Directive are crucial.
Have either of you considered home dialysis? It could be a better option?
Try kidneyschool.org for more info. Feel free to pm me if you need.
Hello KCRG. I’m sorry to hear that your father is suffering so much. Stopping dialysis is something you would need to speak to his nephrologist about. I know I’ve read online before that once dialysis is started, halting it may cause more harm than good. I just wonder though, if your father has only received it a couple of times, maybe it wouldn’t be bad. But as I say, it’s something that a doctor should be addressing.
I also know that dialysis can be hard on the heart (in fact, I’ve heard before that some doctors may even refuse to do dialysis on people with existing heart issues). And I’ve heard that dialysis can take a lot of energy from those that are on it. As for the other issues you mentioned, that concerns me. I’ve never heard of those things happening with regard to dialysis. Is it possible that your father is suffering from other types of digestive issues as well? His medical team should really be looking into this, especially if it is a known fact that he was so active before this procedure.
I will keep your father, as well as yourself, in my thoughts and prayers. Please take care, and do keep us posted on his progress. All my best to you, dear. God bless. 🙂🙏
Are you sure that dialysis is the only contributing factor? My mom had similar issues. She went down hill very quickly but it was not due to her kidneys. She had heart failure and copd. There could be other reasons for the incontinence.
And one more thing, thank you for being so attentive to your Father. I can tell you from experience it is comforting to have family so supportive and caring. While you're doing so much for him be CERTAIN to take care of yourself first and foremost. If you get rundown and sick your Father will have lost his most valued advocate and you could be in a position of needing help as well.
Please feel free to pm me with questions or to chat. Blessings
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