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How are they managing their medications?
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Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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Dialysis will involve having a access to his blood stream surgically - either a special IV catheter that will have 2 hubs that stick out of his skin or an AV shunt (huge, thick area where a vein and artery are surgically connected) under his skin. The access are for a catheter is usually in the neck or chest but some folks have one near their groin. The AV shunt is usually in an arm, but it takes awhile to heal and "mature" before it can be used. He will need to go to dialysis 3 days a week - Monday/Wednesday/Friday or Tuesday/Thursday/Saturday for the rest of his life. Dialysis can take 3-4 hours to complete. He will feel very tired and "washed out" afterwards and many times have muscle cramps. The days he doesn't have dialysis can make him feel uncomfortable since toxins are accumulating. Most dialysis patients have problems with very dry and itchy skin that smells a bit like urine. Lotions and very mild soaps can help this. He will need to follow a special diet and may have to have fluid restrictions.
P.S. I am an RN and take care of dialysis patients (as well as other types of patients) in a hospital.
Who is going to do transportation and is it feasible? Will he sit still for 3 or so hours and not try to get up or pull out lines? That could be deadly. Did you ask about side effects post dialysis? What decisions will be made if he goes on hospice? He most likely never be a transplant candidate. At this time you might want to get a hospice consult to balance the decision making
I'm 86 and competent (at least as far as I know). FWIW, if I could still participate in making a choice, I likely would refuse dialysis and elect hospice/palliative care were I in the elder's position here. From what I've read/heard, the dialysis process is physically draining for the patient and time consuming. Frankly, I'm too old for that!
My 80 yo mom (retired ER nurse) has decided that when she's a candidate for dialysis, she will decline. Quality of life is more important to her than length of life.
- What factors are making this decision difficult? - Does he understand he needs it and what it entails? Would he be compliant with the dialysis? - Who would be driving him, staying with him during dialysis? Is the nearest dialysis center in reasonable proximity? - Does he have other health issues? - Are you his MPoA?
Per your profile, you have a lot on your plate already if you are his main/only caregiver...
Not sure if this applies to your situation but several months ago my husband was told he would need to go to dialysis 4 days a week, 4 hours a day based on his lab work. He is 78 yo; e does not have dementia. He has numerous health issues as he was exposed to agent orange and asbestos when he was in the Navy during the VN war.
We asked if there were any alternatives. The doctors said we could possibly reverse it if we could RADICALLY change his diet. So we met with a kidney specialist and still currently meeting by Zoom with a dietician every month who specializes in this area. By completing changing his diet, eliminating all meat protein, as well as eggs, dairy, and as much potassium as possible (which is very hard on the kidneys), we were able to bring his labs back into range and eliminate the need for dialysis. While I realize this is not possible for everyone, it is worth discussing with his doctors. It isn't easy because of the labor-intensive food preparation (which falls on me). I follow the diet with him to support his efforts. We have to eat extra plant protein and take calcium supplements. If you had told me six months ago it is possible to reverse the need for dialysis just by changing diet, I never would have believed you. But I believe now!! I am also praising God for this turn of events as neither of us was ready to lose him to this disease. The doctors were amazed and say if we can stay on the diet, the prognosis looks good. Best wishes to you both!!
Big decision, especially when you think of all the issues that other people mentioned. My father was diabetic for years, on home dialysis that he managed for several years and then on hemodialysis for years. Late in life, he could hardly walk due to neuropathy and was losing his eyesight, so basically had little quality of life. When he was hospitalized with pneumonia, the hospitalist (who was formerly his personal physician) told my sister that they could cure the pneumonia but not everything else that was going on with our father medically....and that we would have to make a decision sometime about what/how much to do to prolong his life. Along with our third sister, we decided to discontinue dialysis and move him from the hospital to a hospice facility. We had some precious moments with him in his final ten days. So my point is that quality of life is likely to be a major factor in the decision(s) you make now and in the future.
Please discuss options with the doctor and with Hospice. Depending on the stage of Kidney Disease would depend on the life expectancy if he deicides to discontinue dialysis. If dad is fully cognizant he and you and any caregiver should be made fully aware of the process that he will go though. Hospice can help with symptoms and pain management.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
P.S. I am an RN and take care of dialysis patients (as well as other types of patients) in a hospital.
Will he sit still for 3 or so hours and not try to get up or pull out lines? That could be deadly.
Did you ask about side effects post dialysis?
What decisions will be made if he goes on hospice?
He most likely never be a transplant candidate. At this time you might want to get a hospice consult to balance the decision making
From: ElizabethAR37
I'm 86 and competent (at least as far as I know). FWIW, if I could still participate in making a choice, I likely would refuse dialysis and elect hospice/palliative care were I in the elder's position here. From what I've read/heard, the dialysis process is physically draining for the patient and time consuming. Frankly, I'm too old for that!
- What factors are making this decision difficult?
- Does he understand he needs it and what it entails? Would he be compliant with the dialysis?
- Who would be driving him, staying with him during dialysis? Is the nearest dialysis center in reasonable proximity?
- Does he have other health issues?
- Are you his MPoA?
Per your profile, you have a lot on your plate already if you are his main/only caregiver...
We asked if there were any alternatives. The doctors said we could possibly reverse it if we could RADICALLY change his diet. So we met with a kidney specialist and still currently meeting by Zoom with a dietician every month who specializes in this area. By completing changing his diet, eliminating all meat protein, as well as eggs, dairy, and as much potassium as possible (which is very hard on the kidneys), we were able to bring his labs back into range and eliminate the need for dialysis. While I realize this is not possible for everyone, it is worth discussing with his doctors. It isn't easy because of the labor-intensive food preparation (which falls on me). I follow the diet with him to support his efforts. We have to eat extra plant protein and take calcium supplements. If you had told me six months ago it is possible to reverse the need for dialysis just by changing diet, I never would have believed you. But I believe now!! I am also praising God for this turn of events as neither of us was ready to lose him to this disease. The doctors were amazed and say if we can stay on the diet, the prognosis looks good. Best wishes to you both!!
Improve symptoms & quality of life?
Extend life?
Please discuss options with the doctor and with Hospice.
Depending on the stage of Kidney Disease would depend on the life expectancy if he deicides to discontinue dialysis.
If dad is fully cognizant he and you and any caregiver should be made fully aware of the process that he will go though.
Hospice can help with symptoms and pain management.