What are symptoms of chronic kidney disease? Can someone be too frail for dialysis?

Dialysis is a hard way of life. The dialysis client goes to dialysis 3 days a week - Monday, Wednesday, Friday or Tuesday, Thursday, Saturday - for the rest of their lives. On dialysis days, the person goes to a dialysis center for about 4 hours for dialysis. Afterwards, they feel weak and washed out since dialysis tries to remove the toxins and fluids that have accumulated over the prior 24+ hours in 4 hours. Some suffer from painful muscle cramps after dialysis. Almost all have very dry and uncomfortable skin. Lotions help a bit with this. On non-dialysis days, the person usually doesn't feel well since toxins and fluids are building up in their systems. Regardless of day, the person needs to follow a renal diet and usually fluid restrictions.

At 85 years old, this way of life is not very pleasant and probably not realistic to maintain. Since you have already made her a hospice patient, talk with her doctor about her current behavior. The doctor may be able to adjust her medications to help her.

Hi Lainey! Since your mom is elderly and on hospice, I would just give up on the dialysis idea. She's on hospice for a reason and treating her CKD with dialysis just doesn't seem like the right path to me. I would shift my focus to ensuring that her days are pleasant (which may be a stretch at this point) and most importantly, as pain free as possible.

I would also not worry about them not putting in her teeth. It's probably too much effort for all involved. Is she eating the soft diet? Can you get her ensure or something liquid for calories if she's not loving the soft diet. Yogurt has good protein, for example.

As far as hitting the walls, I would ask about a small dose of something for anxiety to help her feel calmer.

Sorry that your mom is failing.

Yes dialysis is hard on a person. I know it sounds counter intuitive, however after the dialysis session, the body takes a little bit of time to get used to the cleansed blood.

When my brother was dying of pancreatic cancer that had spread to his liver, lymph nodes and lower lung, we attempted dialysis since his kidneys were still functioning, but at a significantly impaired level. However, his blood pressure got too low during the dialysis session so we stopped the session. We tried 2 more times, then gave up.

He didn't want to use hospice. He died about 5 days later due to toxic buildup in his system.

I have a friend that goes to dialysis regularly. He goes 3 times a week and it takes him 2-3 hours after each session to feel like himself again.

Our Mom is 90 with stage 4 kidney decease. We have already talked about the possibility of dialysis and the unanimous decision was NO! Mom made it very clear when she made her Living Will that she did not want to be subject to painful treatments of any kind in order to preserve or extend her life. No cancer treatments either so we don't even have her tested (moles) for cancer. She has some dementia and would not understand the PAIN. It would just confuse her and she'd think she was under torture. That's no way to spend your last days. She would prefer death to pain any day. We'd love to have Mom around longer, but not at that cost. As a Christian we know that "death" is not the worst thing that could happen to someone. Comfort is at the top of Moms list these days. So sorry for the medical issues you and your mom are facing.

Yes, dialysis is hard on a body and yes. People can become too frail for dialysis.

I asked my mom's nephrologist when she was late stage but not ready for dialysis along with moderate dementia. Long ago she told me she did not want dialysis. The doctor told me that this is not a painful death because she would lose her appetite and get sleepy which took another year before she passed
Next thing my younger brother had something similar but kidney failure due to inability to urinate for several days. He had a bladder tumor the size of a grapefruit that ended as stage 4. He only lived 6 weeks from diagnosis. He lost appetite and spent most days sleeping. He needed no opiates and quietly stopped away. His kidneys barely put out urine

Laineyisat: As your MIL is on hospice, to undergo dialysis would be extremely difficult, e. g. could she sit in a chair for MANY hours to receive it?

You are facing the same question may of us have dealt with, just different details: are you (considering) doing this to prolong her life or will it just prolong her death? It is very difficult to accept but sometimes inevitable that medical treatment will no longer cure anything and our loved one will not get better. We have decided to make sure Mom is comfortable and knows she is loved, and let nature take its course. This may be where the hospice nurse is trying to point you.

My dad had ckd stage 4 when he passed on hospice. He started wasting away in stage 3 while still eating and was on meds but he never intended on dialysis.

Yes, dialysis is hard on a person especially one who is 85 years old and frail. I agree with the hospice nurse that your MIL is "too old and frail" to put her through such an invasive treatment. There are many reasons her dentures aren't being put in including that they no longer fit properly and hurt her. Let her live out the rest of her days in hospice.

Hospice is end-of-life care:

https://www.aarp.org/caregiving/health/info-2019/hospice-need-to-know/?cmp=KNC-DSO-CAREGIVING-Caregiving-Hospice-NonBrand-Exact-44452-GOOG-Hospice-Exact-NonBrand&gclid=CjwKCAjw_uGmBhBREiwAeOfsd700fhQUIDk2mbfrDXZX7WF8_9myFDWHI9XvblpePLo1ss--cO6wWBoCdeoQAvD_BwE&gclsrc=aw.ds

I agree with red van Annie. On a cancer care unit, I saw patients who had chemo 3x a week. The days between were spent in recovery. They expected to gain six more mos of life this way. I wondered if it was worth it. Chemo also takes a great deal out of the patient.

I’ve had two in-laws and a parent do dialysis. It is three days a week of dialysis and three days of recovery. For an 85 year old I would think that it is too draining.

The decision was made to put her on Hospice so it has been determined by doctors and accepted by family that she is dying and any measures to try and prolong that aren’t worth putting her through. Are you thinking that perhaps her hitting the wall is an indication of pain and dialysis might help that? I think if she were a candidate for dialysis that probably would have been discussed prior to her entering Hospice care but maybe another discussion with her nephrologist and her primary about possible new increased pain is in order. While I think it’s unlikely the nurse is worried about loosing a patient, I think they tend to have more patients than they do nurses, I also think gathering opinions from the various medical professionals involved with your MIL care so her family can make an informed decision is prudent.

The best point made here is what your goal would be in doing the dialysis. If it is to prolong life, and that life is going to be spent mostly at the dialysis center, is that a reasonalbe choice?

I am sorry for your situation. I feel sadness coming through. The decision for or against dialysis may not lie with you but I understand talking it could be helpful. Help discuss the 'what ifs'.

I would like to gently ask the blunt questions;
Firstly, what does MIL's Kidney Specialist recommend about dialysis? IF recommended, for what aim?
For comfort care measures? Or attempt to lengthen life?

I realise thereare many people that value taking all medical measures to prolong a life. There are others that value nature's way. Your families values will shape how you feel.

I would ask, despite not speaking, can your MIL communicate what she wants?
Does she understand about her condition? If so, does she want *invasive treatments*?

While I have not had dialysis treatment, I've met many people that have. They report it is not painful but is tedious. They can feel cool/cold & tired afterwards - but I'm sure that varies. They can show some confusion (due to build up of toxins) on non-dialysys days in end stage. This can sometimes cause distress to relatives.

For younger people on a donor list, dialysis can be a holding pattern until a more hopeful future life.

For me, at advanced age, I value quality of life over invasive treatments.

I have never had dialysis--but I know people who have. It's a real commitment, in fact, on woman I know said her LIFE revolved dialysis treatments, that's all she had 'going on' in her life.

I don't love life so much that I'd opt for that, myself.

If you're waiting for a transplant, that's one thing. If you are simply choosing to treat kidney failure as part of aging--well, that's your choice.

This is definitely one time you need to opinions of the drs and listen to them.

It doesn't appear to be painful, at least. My MIL's kidneys are shutting down and she has not complained of pain of any kind.

Dear JoAnn29, Daughterof 1930 & OncehatedDIL,

Thank all of you for your replies and compassion.
It is much appreciated and helpful.

Bless each of you in your journey. Grace! Grace! Grace!
whew.
Lainey

Dear JoAnn29, Daughterof 1930 & OncehatedDIL,

Thank all of you for your replies and compassion.
It is much appreciated and helpful.

Bless each of you in your journey. Grace! Grace! Grace!
whew.
Lainey

My MIL was having multiple organ failure due to her late stage vascular dementia. The failing of her kidneys caused her potassium level to rise and her heart failed. For her, it was a simple death in her sleep. We were glad she didn't suffer, she'd been through so much already.

We recently lost a relative in her 50’s due to several factors, one being late stage kidney disease. The nephrologists she saw agreed she was not a candidate for dialysis. Since you’re in doubt arrange for mom to be seen by a nephrologist and be sure her medical records are sent in advance. Sorry you’re experiencing such a difficult time

Dialysis is hard on the body. Its not fun either, you sit in a chair for 6 or more hours 3 days a week. I would say just keep her on Hospice where she will be kept comfortable. As the toxins enter her blood stream she will have Dementia like symptoms. She will pass because of the toxins.

So sorry she and you are going thru this.