I am grateful for the collective wisdom of folks on this forum. My dad is almost 92 and has been on dialysis for almost 3 ½ years. He has had some cognitive decline over last 2-3 years but it has gotten worse lately. He will never voluntarily stop dialysis; from what we can glean from a recent conversation, he sees stopping dialysis as suicide (rather than a choice, just like it was a choice to go ON dialysis). He is getting more and more feeble and we feel like we are caught between a rock and a hard place…dialysis is keeping him alive, but at the same time it's extremely hard on his heart and everything else. He’s constantly exhausted; is sleeping more and more. My sister and her husband moved in with him after our mother died, to keep him in familiar surroundings. My sister is POA, and I told her she is not making this decision in a vacuum, but it’s a borderline ethical/moral dilemma to keep him on vs. take him off, and it’s compounded by the fact that he is at some stage of dementia (not formally diagnosed but it’s evident). We’d like to make this decision with him, not FOR him, but we know that we may be forced to, sooner or later. Any advice on how to have a conversation with him about ending dialysis at some point would be appreciated...i f that's even possible. If anyone has been in a similar situation, how did you handle it?
Anything that we do or do not do is a right to treatment and in the case of dialysis amounts to a "right to die" rather than accept certain treatments. I, as a retired RN, long ago wrote into my Advance Directive that I would not accept dialysis even temporarily, nor artificially delivered nutrition of any kind. That was my choice. Your father chose otherwise. He chose to extend his life.
HE STILL CHOOSES dialysis.
It isn't up to you to negate his wishes until truly he has no understanding whatsoever of anything at all, and is living a life of misery and torment and you are asked by his MD to make the decisions for him as his POA.
You do not have choice here, as I see it, to make this decision for your father, who long ago made the decision, is still comfortable with that decision.
Now as to your sister and yourself, you each are within your rights to make your OWN decisions as to much hands-on caregiving you do. I know you know that. I am sorry, and I wish you luck, and I am thankful you are discussing all this with one another and with your Dad. Best of luck. Hope you'll keep up updated. At some point, let your Dad know, when he is exhausted with all of this you will assist him in trying to have dialysis removed in which case he can go into hospice and will be medicated for relief of any pain. Some people without dialysis do "surprise you" by living for quite a lot more time than predicted.