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appygirl Asked August 2015

Papi (80) has CHF and recently began dialysis. Prognosis can't be good. Your takes?

joannes Sep 2015
I am a retired RN and I've known people to live for several years or more on dialysis. It needs to be Papi's choice, but in order for him to make the decisions, he does need to understand that he will be spending 2-3 days each week, at a facility for many hours, sitting there going through the dialysis procedure. And care of the area where the tubes go in, must be carefully done, to prevent infections, and Papi would need to want to follow all the directions he gets from nurses and doctors to keep himself healthy. If this is not something he wants to do, and he refuses, he will die rather quickly because he will not have any way to have all the wastes being removed from the body and will essentially go into kidney failure. My father in law was offered the choice, and he hated hospitals. He was told, that due to cancer, agreeing to dialysis would give him perhaps 3 more months of living, but he refused. He died within 3 days, essentially by going into a coma....it was a pain free kind of passing.

Nana2Nanny Sep 2015
What does he want? Quality? Quantity? I am only 60- i will not prolong any misery. When its time its time. Im not giving a nickel to the medical profession. My mom, who i care for, said "when i get too sick and want to stay in bed- leave me alone, leave me to pass there. No more life sustaining anything. Quality of life has sucked for 10 years - i guess im a tough old bird so when my toughness is done, im done". We never think we have our own choice- we just do what doc says. I guess i live in a different culture. My friend was 50 when he got cancer- he could have fought to live but he said the odds were that he would have a horrible year, a short remission, and ultimately be gone in 5 years. He lived it up for almost a year, fell extreme ill suddenly one day, died in 3 days. Short, relatively easy. Why do we humans delay? Why do we hang onto this physical body? But to each their own

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Gbonnie Sep 2015
I agree with everyones comments. If Papi wants it, go for it. Don't take his hope away. Where there is breath in him, there is life. He isn't struggling. He is a man who wants to live longer. Be supporting to him. Until things get worse.. who knows when that will be, only God. When it is time, death close, or therapy no longer effective. Then start the hospice mode. God bless you,

appygirl Sep 2015
I believe he wont last. This Puerto Rican family believes whatever the eldest som says, though hes incredibly niave. I am a veteran ER nurse and have seen every complication associated with these conditions. But this dynamic keeps them from hearing me. After all, Im an American woman or ,"gringo
". Machismo trumps medicine, go figure.

blondmedicdoglv Sep 2015
As a family member one WANTS to keep their loved one around no matter what. I should know I did the same thing BUT my dad wanted to go. After 6months I finally told him it was OK and within a half hour he transitioned. I do NOT blame his son for trying everything BUT sometimes the person themselves does NOT want to go through all of these living life saving techniques for how much longer? If the patient is coherent enough ask them what they want and abide by what they want. My dad told me he was very unhappy and no more quality of life and wanted to go . None the less I did everything to keep him here UNTIL he decided he wanted to go and did. It is more frustrating for the family as they are left to suffer and mourn but the person who transitioned is out of their nasty physical body and the soul has lived on and begun all over again to live.

KevinKevin1 Sep 2015
Dialysis filters all the toxins from the blood as the kidneys can no longer do it. If dialysis is stopped then the body will fill with toxins and life cannot be sustained. Dialysis is done several times a week and the process takes most of the day. You and your family needs to make the tough decision if Your willing to have Papi go through all of this or not. Maybe ask his doctor for a front up discussion about this and then make your heartfelt decision to continue or not based off that. Good luck. Medical decisions are never easy

JoAnn29 Sep 2015
Smeltzer, 75, at 66 that doesn't seem that old. My Mom is 87. Both the visiting nurse and my daughter, RN at a rehab/nursing facility, have told me not to worry about Mammos and her bladder screening.

JoAnn29 Sep 2015
Doctors will try anything the patient is willing to do. They tried this on my 80+ yr old Uncle. He knew his time was up. Bad heart, bad lungs. He choose not to do anything.

Countrymouse Sep 2015
I'm sorry to hear that; and I'm sorry to say that I think you're right. Who's actually in charge of making the decisions, though? - Papi or POA?

Here is a link to the Edinburgh Renal Unit's public information page about deciding against dialysis, if you want back up; but I'd recommend this site for further reading anyway, even if Papi does want to keep going with it, because it has really good, clear explanations of what's involved and what to expect - I used to rely on it heavily when I was trying to get my head round mother's CKD. Best of luck, I'm sorry for your stress and hope things get resolved.

edren/pages/edreninfo/witholding-and-withdrawal-from-dialysis.php

appygirl Sep 2015
Im ok with him declining as long as hes comfortable. I dont agree with this "salvage" procedure. Hes angry one minute and child like in another. Hes starting 2nd week in hospital having ports placed. His eldest son has HCPOA and insists all messures. He has no medical background at all. He imsists he'll be fine at home. This will be rough amd full of complications. POA is deluded. I dont think Papi is coming home. POA calls me negative. He has no idea.

Countrymouse Sep 2015
How well is he coping with the dialysis, appygirl?

ferris1 Sep 2015
Anyone with CHF and being on dialysis can live years with both conditions, however, at some point in time either or both are fatal. Spend each day with your loved one and make each day count!

Smeltzer31970 Sep 2015
I have been thinking a lot about things like this also, my Mom is 75 years old with dementia, we have stopped routine type screening Mammograms, colonoscopy and such. I would say if he has a strong mind talk with him and see how he feels. in our case I would not put my Mom through it but I think it all depends on the person, Talk with the primary doctor and see if you can get an idea from them.

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