BACKGROUND: As more people survive into old age, a greater number are becoming eligible for dialysis treatment for end-stage renal failure. In the UK the elderly have previously been excluded from treatment programmes, and continuing financial constraints are unlikely to improve this situation. There are few data on the views of elderly subjects on renal replacement treatment. We have, therefore, explored the views of elderly subjects in this study. METHODS: 50 subjects were selected from hospital geriatric wards and nursing homes. A short clinical vignette about a 75-year-old patient with renal failure was presented, and the subjects were asked to give their opinion on choices made by the patient to different treatment options. The subjects were then asked what choice they would make if in the same situation. They were asked what level of symptoms they would tolerate and for their views on cost and treatment allocation. Important contributors to quality of life were also determined for each subject using visual analogue scales. RESULTS: 84% of the subjects would choose dialysis treatment, and 78% of all elderly would attend hospital as necessary, if their symptoms could be relieved. 54% of the in-patient elderly and 83.3% of nursing home elderly even when physically disabled and living in a nursing home would want dialysis for end-stage renal failure. 74% of all elderly preferred to have home dialysis treatment. Only 36% of the subjects thought cost was important when allocating dialysis to the elderly. Being independent and free from major symptoms was regarded as important for a good quality of life. CONCLUSIONS: In this survey, elderly subjects wanted dialysis treatment. Neither age nor cost were considered important determinants for resource allocation. Symptom relief and maintaining independence were considered the main goals of treatment.
BACKGROUND: As more people survive into old age, a greater number are becoming eligible for dialysis treatment for end-stage renal failure. In the UK the elderly have previously been excluded from treatment programmes, and continuing financial constraints are unlikely to improve this situation. There are few data on the views of elderly subjects on renal replacement treatment. We have, therefore, explored the views of elderly subjects in this study. METHODS: 50 subjects were selected from hospital geriatric wards and nursing homes. A short clinical vignette about a 75-year-old patient with renal failure was presented, and the subjects were asked to give their opinion on choices made by the patient to different treatment options. The subjects were then asked what choice they would make if in the same situation. They were asked what level of symptoms they would tolerate and for their views on cost and treatment allocation. Important contributors to quality of life were also determined for each subject using visual analogue scales. RESULTS: 84% of the subjects would choose dialysis treatment, and 78% of all elderly would attend hospital as necessary, if their symptoms could be relieved. 54% of the in-patient elderly and 83.3% of nursing home elderly even when physically disabled and living in a nursing home would want dialysis for end-stage renal failure. 74% of all elderly preferred to have home dialysis treatment. Only 36% of the subjects thought cost was important when allocating dialysis to the elderly. Being independent and free from major symptoms was regarded as important for a good quality of life. CONCLUSIONS: In this survey, elderly subjects wanted dialysis treatment. Neither age nor cost were considered important determinants for resource allocation. Symptom relief and maintaining independence were considered the main goals of treatment.
Authors: Osasuyi U Iyasere; Edwina A Brown; Lina Johansson; Les Huson; Joanna Smee; Alexander P Maxwell; Ken Farrington; Andrew Davenport Journal: Clin J Am Soc Nephrol Date: 2015-12-28 Impact factor: 8.237
Authors: Edwina A Brown; Lina Johansson; Ken Farrington; Hugh Gallagher; Tom Sensky; Fabiana Gordon; Maria Da Silva-Gane; Nigel Beckett; Mary Hickson Journal: Nephrol Dial Transplant Date: 2010-04-16 Impact factor: 5.992
Authors: R Selgas; A Cirugeda; A Fernandez-Perpén; J A Sánchez-Tomero; G Barril; V Alvarez; M A Bajo Journal: Int Urol Nephrol Date: 2001 Impact factor: 2.370
Authors: Allison Tong; Suetonia Palmer; Braden Manns; Jonathan C Craig; Marinella Ruospo; Letizia Gargano; David W Johnson; Jörgen Hegbrant; Måns Olsson; Steven Fishbane; Giovanni F M Strippoli Journal: BMJ Open Date: 2013-01-24 Impact factor: 2.692