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PEACE OF MIND                                         HOW WILL I DIE?
           To ensure your peace of mind it is advisable,         This is impossible to predict. As time goes on and
        at this time, to consider the following:              as the end gets closer, some people become
                                                              progressively weaker and may slip into a coma.
        1. Making a will.
                                                              Symptom management will be adjusted to provide
        2. Discussing with your family personal               maximum comfort at this stage.
           preferences about your future care, in the
           event that you were unable to make                 WHAT ABOUT MY FAMILY?
           decisions for yourself. Given that you may            Help and support will be offered to your
           live for a number of years with                    family throughout your on-going conservative
           conservative management, would you                 management, as required. Contact details will be
           want to be resuscitated if you suffered a          provided at the kidney clinic.
           cardiac or respiratory arrest? Would you
           want to be put on a ventilator?                    IF I START DIALYSIS,

                                                              CAN I STOP IT?              “Any patient
           These are very difficult questions, but, by           Yes. Any patient         who opts for
        you giving them some attention now, you               who     opts    for    dialysis is entitled to
        might prevent a very difficult situation for          dialysis is entitled
        your family.                                          to stop dialysis if it   stop dialysis if it
                                                                                      becomes too much
                                                              becomes too much
        — Should you decide not to opt for                    for them. Sometimes,          for them.”
           resuscitation,   this   will  be    clearly        the patient comes to
           documented in your chart.                          this decision first and other
        — You have the right, at all times, to change         times it may be suggested, by the medical team, if
           your mind and opt for dialysis and / or            it is apparent that dialysis is no longer suitable or
           resuscitation if this is medically feasible.       beneficial to the patient.

                                            WITHDRAWAL OF DIALYSIS
               If dialysis treatment is no longer possible or tolerable, the aim will be to make you as
             comfortable, as possible, by carefully managing symptoms and supporting for you and your
             family through all stages of the dying process. No two people will experience discontinuation
             of dialysis in the same way, so each person’s circumstances will be supported as appropriate
             to them. Some people will opt to die at home, supported by their GP and community nursing
             services. Others may prefer to be in hospital when the time comes.
               While talking about end of life issues are difficult, many people experience a sense of relief
             at bringing the discussion into the open. It helps ensure that your wishes are known and can
             be honoured. It is also helpful, to your family, to know beforehand what your wishes are.
               The staff of the kidney unit welcomes the opportunity to discuss and explain further any
             issues raised in this article.

        P.26 Haemodialysis and Peritoneal Dialysis – A Guide for Patients
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