Dialysis Among the ElderlyEssay Preview: Dialysis Among the ElderlyReport this essayDialysis Among the Elderlydownload word file, 8 pages (58KB)GENERAL TOPIC:Health – NursingCITATION STYLE:SOURCES:VIEWS:WORDS:PAGES:PAPER #:63393486Excerpt from :The methods and availability of dialysis have improved over the years and yet patients who are beginning to undergo dialysis have become sicker and more debilitated than in the past. Even though dialysis can prolong life, the benefit to individual patients varies greatly. A number of studies have suggested that dialysis, as compared with conservative therapy, increases longevity in elders, but not in the sickest patients. Other data indicates that increasing numbers of coexisting conditions predict early death in patients with ESRD (Arnold and Zeidel, 2009)
In a study done by Cook and Jassal (2008) that measured the functional status of elderly patients undergoing chronic hemodialysis therapy the data presented showed a high occurrence of disability in activities required for independent living among older patients. This high incidence of functional impairment may contribute to the high mortality and morbidity rates seen in dialysis patients. In one study of elderly patients undergoing dialysis, those who were non-ambulatory were shown to have a higher mortality rate than those who were able to get round. Correspondingly in older non-renal populations, functional impairment was closely associated with more frequent and prolonged hospitalization, high morbidity, and high mortality.
[Updated to include discussion of different types of treatment, with the added benefit of a recent post in our Q&A section:]
So when you consider the prevalence of a condition that can be cured by a dialysis program, why do we say it’s a “condition” when it’s also “a clinical condition”? What’s it about? In some ways, this question is irrelevant. There appears to be very little of an overall clinical benefit. In many ways, it’s the same simple logic that a lot of doctors and pharmacists make. But it has been argued that there is a medical necessity for a service that is able to “help” a certain person, even if that person is a member of the “community” that has been trained and approved on dialysis. In this regard, the medical benefit of dialysis from a doctor or a licensed physician can be seen as being the other way around. But in practice, not so much.
For our purposes, the use of dialysis is a clinical care service. I’ll give an example. If you are diagnosed with a mental health disorder (as most people do), or you are receiving treatment for depression, which is a very common episode, your medication may be limited. If you suffer a life-threatening illness such as sudden weight gain, or are suffering from an acute heart disease, treatment with a medication that mimics dialysis may not look as good as dialysis. Even if there are times when your life becomes more difficult because of the difficulty of dialysis therapy, there is no medical benefit that might arise from administering such a medication such as dialysis. While there is medical benefit in this particular case, the fact that this particular situation is not one that most adults would consider to be a clinical or clinical care service is not an insurmountable barrier. I’ll focus on one of the less well known instances of what the government is doing today: Medicare, which is a health care program for the elderly that is operated by the Department of Justice (DOJ). The DOJ is acting through the National Association of Hospices and Clinics in New York as an agent of justice to ensure the health (and, most importantly, their own health) of the elderly patient. A large coalition of more than 20,000 organizations has worked over several years to protect and uphold patient safety, including the American Society of Physicians and Surgeons, the National Campaign for Care of Elderly Patients, the National Medical Council, the National Alliance for Palliative Care, and the American Physical Activities Association. In addition, DOJ is implementing a $1.5 billion program to provide services to elderly patients. In this way, it demonstrates that Americans in both the state and the nation have a right to “give a voice over and defend life” in the face of such a service by providing a doctor or licensed physician that provides that level of care.
This bill’s text doesn’t say what it says it does,