| Author | Subject: Any advive is greatly appreciated |
| Jack | Posted At 21:36:44 06/28/2002 Hello, A close member of our family was taken off dialysis today because his blood presure was too low. He will try again on Monday but the chances are that he will not be able to dialysize and will die within a week or so. He is 84 and has been on dialysis for 5 years. We are thankful for the time we have had with him. My questions are: Is there anything we can do so he can get treatment (foods to raise blood pressure, medicines, etc.)? In the event that we can't do anything to sustain his life, is there anything we can do to help him over the next several days? Any advice is greatly appreciated. Thank you. |
| Beth Witten | Re: Any advive is greatly appreciated (Currently 0 replies) Posted At 15:49:01 06/30/2002 I'd suggest you place a call to your father's nephrologist and ask what he/she thinks is causing your father's low BP. Before you call: 1) Make a list of his medications, strength, how many of each (over-the-counter and prescribed by any doctor) he takes and when he takes them on dialysis days and non-dialysis days. 2) If he has a BP monitor at home, check his BP after he's awake and doing regular activities. 3) If he has a scale at home, check his weight in the clothes he normally wears to dialysis and report this to the doctor. The scale at home and at the dialysis unit may not register the same but this might give the nephrologist a general idea. 4) Check his temperature. 5) Ask your father how recent treatments have gone at the clinic, especially whether BP problems been occurring often and what they've done to correct the problem in the past. These are the types of things the nephrologist would ask a nurse at the clinic to report if he/she calls to report a patient problem. Surprise the nephrologist and have the information ready. Also let the nephrologist know and any changes that you're aware of in your father's food or fluid intake, medications, activities, etc. If your father wants to continue to receive dialysis (continuing dialysis is his choice if he's competent), I would ask the nephrologist if there is anything that anyone (your father, the family, or dialysis clinic personnel) can do to help maintain his BP at a level where dialysis can be performed. It could be that a medication or dosing schedule needs to be changed, his "dry weight" needs to be increased or his dialysis prescription changed, or his cardiac status or other physical condition needs to be evaluated. If dialysis is no longer possible, the nephrologist should be able to tell you what he/she can do for your father and the family. He/she can also recommend what you and the rest of his family can do to make your father comfortable and tell you what you and your father might expect during the time he has left. Ask the nephrologist for a referral to a hospice agency. A hospice agency can provide nursing care for your father and emotional support for your father and your family. Hospice services are usually covered by insurance or Medicare. Finally, I'd suggest that you ask your father if he would like to talk with his minister, priest, rabbi or other spiritual leader. This often makes it easier for someone come to terms with death. Be aware that there may be support groups in your community to help your family after your father dies. The hospice agency or the dialysis social worker may be able to suggest how to locate a grief support group. |