When the patient does not take part in the assessment process for dry weight and goal because he is uninvolved with his tx (i.e. eldery, uneducated, mentaly challenged),is it possib;e to assess an accurate goal or do these patients have many more problems wwith cramping, hypotension than an involved, educated patient?

I would think it would depend on the efficiency of the staff. I know as a home partner I can see signs when the dry weight is off.

AS A FAMILY MEMBER WITH AN ELDERLY PARENT ON DIALYSIS (WHO IS FULLY COGNIZANT AND UNDERSTNDS) IT IS MY BELIEF THAT IF THE PATIENT DOES NOT PARTICIPATE DUE TO VARIOUS CIRCUMSTANCES,,, 1. CAN A FAMILY MEMBER ASSIST 2. AGREE WITH PRIOR POST, THERE MUST BE AN EFFICIENT STAFF WHO IS ALERT TO CHANGES AND KNOWS WHAT THEY ARE DOING..?

I HAVE LEARNED... 1. ANY SHORTNESS OF BREATH LYING DOWN, DIFFICULTY BREATHING 2. SWELLING AROUND EYES, ANKLES,,, ETC... HOPEFULLY THE STAFF WILL CHECK HIS LUNGS, LOOK AT HIS ANKLES,,,

IF THE PERSON LIVES WITH SOMEONE, PERHAPS THT PERSON CAN HELP WITH GIVING INFORMATION

I was re reading your question. I think it depends on where the patient is living, a nursing home, home, etc.? If it is in a nursing home, the dialysis staff can send a form that has information to guide the nursing home staff. This guide will give information for the staff to look for, i.e. shortness of breath, etc...

quote:

Originally posted by Lewis:
When the patient does not take part in the assessment process for dry weight and goal because he is uninvolved with his tx (i.e. eldery, uneducated, mentaly challenged),is it possib;e to assess an accurate goal or do these patients have many more problems wwith cramping, hypotension than an involved, educated patient?

This is not exactly what I am asking. Only an alert patient knows how he feels in relation to the goal that was previously set, if he has gained or lost real weight, if he had a bowel movement, his blood pressures,etc. The staff is making a quesstimate. So is the patient. But my point is, the aware patient has more tools to make the quesstimate with. Most of all, he is the one on the machine and knows how he feels - something the staff can not ever experience. So, my question is, without the patient's participation in estimating the dry weight and goal, I don't see how staff can set as accurate a goal as the patient himself can.

I do think a family member or a well trained staff could be in a position to assist the patient asertain what his dw and goal is, but to get really accurate, I feel the patient's input is necessary.

For the tx to be well balanced, an accurate assessment of dw and goal must occur. I've been in numerous units and have observed that the asseessment process is very rushed and anything but accurate. I once asked my doctor how he knew what my dw is and he replied, "It's just a guess". Therefor, I have learned to do my own assessment.

One of the best procedures that I have found is to 1.gather the data,evaluate trends,use UF and or NA modeling one at a time ,evaluate,involve patient, and then you should be close to the real dry weight.Also the Crit-Line Monitor can be utilized as a tool to see profile changes as they occur,therby reducing morbidity during the Dialysis Procedure

lEWIS, Iagree,,, and with the next post,,, although i am new to this dialysis, as a family member, i feel the assessments need t be more than just taking the weight prior to dialysis and subtracting from goal.. there is alot that goes into this assessment...and, i am learning every day