Planning for a good death: a neglected but essential part of ESRD care.

Planning a "good death" is a neglected, but essential, part of the care of patients with end stage renal disease and their families. Many of these patients do not have advance directives and few utilize palliative care. Guidelines from medical and specialty nursing organizations regarding end-of-life (EOL) issues and palliative care have been developed, but they are not consistently used by the nephrology community. Nephrology nurses are frequently positioned to begin EOL discussions with patients and families, and advanced practice nurses are in a unique position to coordinate and facilitate a patient's transition from chronic to terminal illness and to increase the likelihood that the patient and family experience a "good death". This article reviews the need for practice improvement in EOL care and a review of the current literature.