After working as a renal social worker for a few years I have recently taken a position at a nursing home where there are a growing number of residents in need of dialysis. The closest dialysis unit is almost an hour away, the nephrologist does consultation visits with the pt's. but there is little if any communication or education about ESRD, or dialysis for the nursing home staff, pt's or their families. My delema is that often the quality of life the pt. has prior to starting dialysis is quite minimal and the prospect of them having to undergo dialysis, which they may not understand, want or truely benefit from is truely heart breaking. Any suggestions how to effect some positive outcome?

It seems to me that it is an important part of the social worker's job to educate people. Why not hold information sessions for the staff and separate ones for the families and patients. There is a lot of information out there that you can gather in addition to your own experience to educate people and guide them through their decision making process. We often tell people that dialysis a difficult choices that travelling will be very tiering. I am often amazed that most people despite the difficulties choose to try dialysis. I encourage you to make a difference and start the education process. Be a ground breaker, make a difference!

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Originally posted by marge:
After working as a renal social worker for a few years I have recently taken a position at a nursing home where there are a growing number of residents in need of dialysis. The closest dialysis unit is almost an hour away, the nephrologist does consultation visits with the pt's. but there is little if any communication or education about ESRD, or dialysis for the nursing home staff, pt's or their families. My delema is that often the quality of life the pt. has prior to starting dialysis is quite minimal and the prospect of them having to undergo dialysis, which they may not understand, want or truely benefit from is truely heart breaking. Any suggestions how to effect some positive outcome?

To help staff understand kidney disease and treatment, the National Kidney Foundation of Michigan published a binder of helpful information. Included is information about kidney disease, treatment, diet, etc. I'm not sure if this is still being published, but you could check with the NKF of MI at 734/971-2800.

To educate pre-dialysis patients, as Diane said, materials are plentiful and often free. Many publications are posted on the Internet. One of the best sites I've found is www.chid.nih.gov. You can search this database of education materials for a specific illness (kidney disease, diabetes, etc.). The detailed search allows you to look for specific formats (video, fact sheet, CD ROM, etc.), topics (diet, coping, etc.) and languages. Once you find things that sound appealing, you can click on a link and read more about the item and how to obtain it, including cost.

I don't know whether the nursing home where you work has enough patients to warrant it, but some nursing homes offer hemodialysis onsite. Others have chosen to learn how to assist patients who need help with PD exchanges.

As you probably know, most people fear the unknown and the more they can learn often helps them be less anxious about starting dialysis. Well adjusted peer helpers can be invaluable in showing those facing kidney failure that quality of life after dialysis is possible but it takes keeping hopes and dreams alive, setting goals and sometimes hard work to achieve your goals.

Thank goodness that you're there. With your renal social work experience you should be a great resource to these nursing home residents and their families.