My Mom (95) will probably need dialysis. Any advice?

Thanks for all responses, I'm appreciating the suggestions and support more than you can know :)

Talked to Dr.s office yesterday, and regarding the urine collection he wants it done with the "hat" for the toilet. Get as much as possible caught in the "hat" over the 24 hr period, then catch the "first urine" of the next morning plus one additional urine catch that next day, and that will suffice. He said he just needs a "ball park" to see about creatinine and potassium levels.

There is a dialysis clinic right here in town. Her doctor is not associated with this clinic and would not be able to continue to be her doctor -- she'd need to transfer her case to the doctor who handles the clinic here. Problem is, Mom had some consult with this local doctor (nephrologist) several years ago over something, and did not LIKE this doctor. I don't know whether or not this local doctor is a good nephrologist.

Wow 95 and on dialysis! If I were you I would sure get a second opinion and I would try and talk to some nursing staff who work dialysis. I'd even try and talk to some pts undergoing dialysis. This is not going to be a walk in the park so be sure and get as much info from as many sources as you can before you make your decision. I sure hope she won't need dialysis.

Maybe she won't need dialysis. At age 95 it is common for some decrease in kidney function. What blood work has she had done? I would wait until all the results are back before making any decisions.

AZLife, you are thinking right about how dialysis can consume a large part of your life. Some people on dialysis receive a mild sedative to help them sleep while it is being done. Other people prefer not to do this. I was thinking of how much more difficult it will be since it is an hour away. I know there are some services that will come for home dialysis, but I don't know much about them. Your mother's doctor may not be in favor of that, since dialysis is not without risks. Still I would ask him about it. You wouldn't be able to take your mother and leave her with the center being so far away. If the center is close, people can take someone, then come back to get them later.

What I'm hoping is the dialysis is not necessary.

Perhaps you can get a reliable neighbor or teen to take care of the dog, feed it and/or walk it once while you're gone.

As to the reallocation of time, try to find a way to get something done that you wouldn't do otherwise - read a book, magazine, take a nap while dialysis is taking place or dash out to get some shopping done. Otherwise it will seem like a lot of time lost.

And it's very likely that you'll both be exhausted the following day, so plan on just resting up. Weekends can be for shopping, etc. so you have the week free to focus on making the dialysis as minimally unpleasant as possible.

Okay, I think what I need to do is call her doctor's office back and ask them about the Foley catheter for the 24-hr collection, see how we can get that arranged to be done.

As far as whether or not she wants dialysis ... she's of sound mind, so she is capable of making the decision. As her hearing is not great, she didn't catch everything the doctor said, but I explained to her during the drive home and she was accepting of the idea.

What I think she may not grasp -- in fact, this just hit "me" today -- is how much of our daily lives dialysis will eat up if in fact it's what the doctor wants her to do. Assuming she is scheduled in the afternoons, that will be 3 days a week that will include rushed mornings to make sure she's up on time to eat breakfast and be ready to go to the treatment so we can get there on time. By the time we get back home it will be nearly time for dinner, so no nap time for me even though hopefully she'd nap during treatment. Our dog will need to be crated while we are gone, so that's about 5 hours of crating a day for her ...

Just things I'm thinking about.

With regard to mom bring a hard stick, I was told by a phlebotomist that it was ok for my mom to drink water before she came because she was not getting any blood otherwise. My mom was being discharged from hospital to at home hispice in the afternoon. The morning of discharge my sister, who spent the night, called and said moms iv blew out 2x and nurses couldn't get it and they were waiting for a phlebotomist. I told them to not stick her anymore she was going home that day. They were not happy but finally agreed. My mom came home with 2 black and blue arms and hands. She died a little over 2 weeks later and was still all black and blue. I know getting the blood was important but I felt like it was torture. I think I just got to the point where enough is enough and had to make them stop. Good luck with your mom

If you have visiting nurses come they could do the foley cath. Does your mom want to have dialysis? Is she able to make this decision? I haven't read your profile but am going to do that now.

The lab would not put in a catheter. It would have to be placed at the doctors office. The foley would ensure that all the urine is collected. There is no way the urine in the depends can be collected or analyzed. The 24 hour lab test will not be accurate if all the urine is not collected and tested. I worked with several urologists and have placed numerous Foley catheters in patients both in office and home health visits for the purpose of a 24 hour collection.

Re Foley catheter -- he didn't mention it and I never thought to ask ... would this be something the lab could do if he put in an order for it?

Not being able to catch all the urine in a 24 hour collection will definitely affect the lab results. Possibly giving false/negative results. Is there anyway your mothers doctor might place a tempory Foley catheter to collect all the urine?

Yes, the doctor gave us an order for the bloodwork and it includes the lab then giving us the collection pan and a bottle for the urine collection.

If Mom wants to keep him as her kidney doctor -- which she does and I agree, as we have a good rapport with him and his staff and have been very pleased with her care -- he is only affiliated with one dialysis clinic, and that is nearly an hour's drive from Mom's home. So we're talking 3 entire afternoons a week (hopefully she will be scheduled for afternoons). This would be easiest on her, as she normally naps in the afternoons, so she could nap during the treatment or maybe read if they can adjust lighting for her.

Az, i know that you are far from most of mom's doctors. Does she have a geriatrics doctor? Can you call back the kidney doctor and ask him the questions you've asked here? And can you ask him frankly about the advisability of starting dialysis? This is not something that i would put my 92 year old mother through.

Did your doctor give you one of those pans that set on the toilet seat to collect urine? You can only collect what can be caught. Talk to them about getting one of the collecting pans. It can be emptied into a container each time she goes so it doesn't evaporate.

I'm afraid that the vein problems will be up to the medical staff. I've seen some very bad vein damage from dialysis. One of my friends had a vein made for her and permanently inserted. It made it easier.

I don't envy her the dialysis. It takes so much time I wish she didn't have to go through it. Maybe her tests will continue to be good enough.