Patients diagnosed with end-stage renal disease, also known as end-stage kidney disease, require specialized care at the end of life. Hospice for renal disease helps patients maintain the best possible quality of life during those final days, weeks or months by providing symptom management, assistance with everyday tasks, emotional support and relief for primary caregivers.
Instead of viewing hospice as giving up on life, it should be considered a way to face the end of life with dignity. The goal is never to hasten death but to keep the patient comfortable and improve quality of life during the end stages of kidney disease.
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Hospice Criteria for Renal Disease Patients
Kidney disease affects the body’s ability to filter waste products out of the blood, maintain blood pressure and remove excess fluid from blood. During the end stages of kidney disease, one or both kidneys fail completely. Toxins build up in the bloodstream and eventually lead to organ failure throughout the body.
Patients with chronic kidney disease may be eligible for hospice services if they:
- Are ineligible for dialysis or a kidney transplant
- Have a creatinine clearance level of 8.0 mg/dl or higher without diabetes or 6.0 mg/dl or higher with co-occurring diabetes
- Have a serum creatinine clearance of 8.0 mg/dl or higher without diabetes or 6.0 mg/dl or higher with co-occurring diabetes
- Are older than 60 and have co-occurring conditions such as heart disease, chronic lung disease, malignant cancer, chronic obstructive pulmonary disease or advanced liver disease
Typically, hospice for renal disease is designed for patients with a life expectancy of 6 months or less. Patients entering hospice must not be pursuing curative treatment for the disease. This includes treatment options such as dialysis and kidney transplants.
In some cases, a patient may be eligible for dialysis but choose to not pursue this treatment option or to halt dialysis when the signs of kidney failure reach a specific level. Patients eligible for dialysis treatment who make the choice to discontinue dialysis may be eligible for hospice if they meet the above criteria, while current dialysis patients may be eligible for palliative care.
Choosing Hospice for Renal Disease
Deciding when to enter hospice involves discussions between the patient, the patient’s caregivers and the patient’s doctor or healthcare professionals. Caregivers might include adult children, a spouse or family friends helping care for the renal patient. Referrals are typically made by a primary care physician, but caregivers and patients can request a referral.
If a patient doesn’t meet the criteria for hospice care, palliative care may be another option. With palliative care, kidney patients may continue to pursue treatment options such as dialysis. Patients who have a life expectancy of more than 6 months may also opt for palliative care if they require extra assistance beyond what family members or friends can provide. Palliative care includes many of the same services as hospice, including managing symptoms and assistance with everyday tasks.
Consider discussing hospice options before kidney disease reaches the end stages to ensure everything is in place when the time comes. Because this disease is progressive, kidney disease patients can consider the typical stages of symptoms and decide what specific disease milestones should necessitate the start of hospice care.
In general, hospice patients are less likely to experience emergency hospitalization than kidney failure patients who don’t utilize hospice services. Chronic kidney disease patients who require significant end-of-life care can also cause their caregivers emotional and mental stress, and hospice helps relieve this burden.
Three Oaks Hospice Locations
Three Oaks Hospice has locations across the U.S., ensuring that caring, compassionate hospice and palliative care are available to patients where they live. Three Oak Hospice provides on-site care in the home or where the patient calls home, whether that’s in their residence, a family member’s, or in a medical facility.
How Hospice Care Helps Patients With End-Stage Renal Disease
When a patient with end-stage kidney disease opts to enter hospice, this choice is intended to help improve quality of life and manage pain or other symptoms. Patients first receive a hospice evaluation that helps the hospice staff determine what services are required for effective end-of-life care and whether the patient has specific care goals in mind, such as remaining in the family home or managing specific kidney failure symptoms. Care is personalized, so each member of the hospice team is chosen based on the patient’s needs and desires.
Symptom Management
Patients with kidney failure may experience pain and discomfort, and if another organ system is affected, this pain can be systemic. Managing pain in hospice can involve doctor-prescribed medication as well as alternative methods of pain control. The hospice team works with the primary care physician to monitor symptoms and adjust the care plan when needed.
Patients with end-stage renal failure may also experience symptoms such as fatigue, loss of appetite, nausea, difficulty sleeping, itching and mental health issues. Nutrition specialists on the care team can help develop a healthy eating plan for the hospice patient, while nurses may provide wound care for patients. The overall goal of symptom management is to optimize the patient’s comfort.
Coordinated Care
Coordinated hospice care includes cooperation between family caregivers, the primary care physician, the hospice team and the patient. Members of the hospice team might include nurses, counselors, physical therapists, social workers, clergy members and hospice volunteers. Hospice team members might visit a patient daily, multiple times a week or once a week, depending on the patient’s needs and priorities.
Because care is personalized, the patient’s specific desires are taken into account. Whether a patient wants to remain in the family home during the end of life or has a desire to reduce the care burden on family and friends, the hospice plan is designed with these goals in mind.
Personal Care
Everyday tasks such as personal grooming, meal preparation, using the restroom and bathing often become more difficult as renal disease progresses and the patient’s physical condition deteriorates. Nurses, home care assistants and volunteers on the hospice care team provide supportive care that includes assistance with everyday activities, ensuring the patient continues to maintain a good quality of life.
Emotional and Spiritual Support
Hospice patients often need extra mental, emotional and spiritual support. Counselors and clergy members provide therapy sessions to talk through end-of-life issues, spiritual guidance and mental health care for patients experiencing anxiety or depression related to their terminal illness.
Medical Supply Assistance
As part of the initial hospice assessment, the hospice team coordinator determines what medical supplies and equipment are necessary for consistent care. Hospice staff can help set up necessary medical equipment, and basic medical supplies such as bed pads or medical gloves are provided by the hospice team.
In-Home Care
Hospice services are typically provided at the patient’s place of residence. This might be at the patient’s home, a family member’s home or an assisted living facility.
Convenient 24-Hour Care
Patients can access care 24 hours a day. Three Oaks Hospice provides on-call access to nurses and other members of the hospice team to ensure care is available whenever the patient needs it. Frequent visits by hospice team members provide consistent, reliable care on an ongoing basis.
How Hospice For Renal Disease Helps Families and Caregivers
Family members or friends who provide caregiving for a patient with end-stage kidney disease also benefit from hospice services. Caregiving duties can become overwhelming, and hospice professionals take on some of the burden to help relieve this stress. This allows family and friends to spend more quality time with the patient.
Caregiver Education
Caring for a patient with renal failure can be complicated, and Three Oaks Hospice helps caregivers understand the progression of end-stage kidney disease as well as giving information about best care practices for patients with decreased kidney function.
Respite Care
When family caregivers need a break, respite care is an option. Respite services include 24-hour care on a temporary basis to allow the regular caregiver time to complete personal tasks or take a short mental health break.
Bereavement Services
Three Oaks Hospice offers emotional support for families dealing with a loved one’s illness. Families get up to 13 months of bereavement services after a patient’s death. This might include grief counseling and visits with an on-staff clergy member.
Paperwork Management
The social worker assigned as part of the hospice team can help patients and their families manage everything from Medicaid eligibility paperwork to funeral arrangements. The hospice care team can also help patients set up an advance care directive.
Paying for Hospice and Palliative Care
Patients who meet the eligibility criteria for hospice care often receive coverage for these services through Medicare, Medicaid or private health insurance providers. Talk to your hospice care team to get help with any insurance or financial paperwork required for coverage.
Access Hospice Care for End-Stage Renal Disease Patients
Three Oaks Hospice offers a wide range of hospice services for patients with end-stage kidney disease and other terminal illnesses. If you or a loved one is in need of hospice for renal failure, contact us.