What happens if patient refuses dialysis

Your doctor will prepare the vascular access weeks to months before dialysis starts. The access is usually in an arm. Dialysis is done mainly by trained health professionals who can watch for any problems.

You will need dialysis on a regular basis, usually several times a week. In some cases, hemodialysis can be done at home. You will need to be trained, and will need to make room for the dialysis machine. You may have choices for how often and how long you need dialysis. Peritoneal dialysis uses your body's own tissue the peritoneal membrane as a filter to clear wastes and extra fluid from your body and to return electrolyte levels to normal.

Unlike with in-center hemodialysis, you don't need to travel to a dialysis center for your treatment. Peritoneal dialysis is done every day. It can often be done at night, while you sleep. You will need to have a catheter dialysis access placed in your belly before you start dialysis. If you don't have dialysis, your kidneys will continue to fail and you eventually will die.

How long you could live depends on your overall health aside from your kidney disease and how much kidney function you have left.

If you don't have dialysis, health professionals who provide end-of-life care can help you have the highest quality of life possible. This may be done through hospice care. Hospice offers the chance to think about personal goals, relieve pain, and take care of your emotional and spiritual needs.

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I want to have dialysis, because I'm not ready to die. I still feel young. I have a lot of things I still want to do with my life. I want to work on my craft projects and spend more time with my grandchildren. I have other bad health problems. I've had heart attacks, and I also have heart failure.

I don't think dialysis will give me much more time. I feel like I've had a good life. I'm ready to go whenever it's my time. I know I'll spend a lot of time at dialysis. But I can read there. And I love writing letters to family and friends.

My partner can drop by sometimes and spend some time with me, and maybe I can make some friends at the dialysis center. I want to spend the time I have left with my family, not having dialysis. My daughter said I can come live with her, so I can spend more time with her and her husband. Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

I don't want to keep relying on others for help with my dialysis treatments. I feel pretty good overall, because kidney failure is my only major health problem. I'm already sick from other health problems and am not sure dialysis will help me feel any better or live any longer. Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision.

Show which way you are leaning right now. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. I don't mind having to rely on others for transportation or other help. I may be able to have dialysis at home and not go to a center. Are you clear about which benefits and side effects matter most to you?

Do you have enough support and advice from others to make a choice? Author: Healthwise Staff. Medical Review: Anne C. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Updated visitor guidelines. Get the facts. Your options Start kidney dialysis, which may help you live longer. Don't start dialysis, which will allow death to occur naturally.

Key points to remember It's your choice whether to have dialysis or not have it. Planning for care and respecting the wishes of the patient makes end-of-life decisions easier. All adults should have an advanced directive. Having an advance directive lets everyone know what to do if you become unable to communicate those wishes. If you have questions about an advance directive, please talk with your physician or an attorney.

When someone has made the decision to stop dialysis, hospice can be referred by their physician. For more information on hospice, talk to your physician. Without dialysis, toxins build up in the blood, causing a condition called uremia. The patient will receive whatever medicines are necessary to manage symptoms of uremia and other medical conditions.

Depending on how quickly the toxins build up, death usually follows anywhere from a few days to several weeks. As the toxins build up, a person may experience certain physical and emotional changes. In the final days, the body starts to shut down. In most instances, the shut-down is an orderly series of physical changes which may include:. Patients who choose to stop or not start dialysis are not required to eat or take in fluids.

In most cases, a patient is allowed to eat or drink if they want to, but forcing fluids or nutrition is not recommended. Medicines can be given for pain, anxiety, agitation or congestion.

These are almost always people who have developed other serious illnesses after starting dialysis. Often if doctors mention dialysis to you they will tell you if they think it will be very difficult for you. If they have not discussed this, you should ask. It is also important that you discuss it with your family and close friends. You will go through the disruption, inconvenience and dangers of dialysis, and may end up feeling worse and in hospital. Dialysis may cause serious complications and bring about an earlier death for some people.

Some people disagree with this view and commonly recommend a trial of dialysis. We would probably recommend it to a patient if we thought that they were being unnecessarily pessimistic about how they would feel on dialysis. But in the end it would be your choice whether you followed this advice or not. It is very rare for this question to arise.

Sometimes it is obvious to all involved that dialysis would be unhelpful. For example the patient is likely to die very soon from another condition, or dialysis may worsen quality of life with very little prospect of gain. Almost always the patient understands this when they are capable, but frequently this question arises for patients who are not well enough to be able to make their own decisions.

The decision then needs to be discussed carefully with family or carers. Occasionally family members may have unrealistic expectations about what dialysis might achieve. In some countries it is unfortunately not possible to provide dialysis for everyone who could benefit from it.

This is not the case in most wealthy countries in western Europe or North America, but is common elsewhere in the world. On the other hand, some people believe that in some western countries dialysis is used too much, and that some patients are being given only slightly longer lives, and an unhappy death.

Britain is on par with other European countries in providing dialysis places, and numbers have expanded hugely over the last 20 years. No units operate an age barrier or other fixed limitation on who can be treated.

Every patient is considered individually. The law in Britain permits anyone to refuse treatment that might keep them alive, as long as they are able to understand the decision that they are making. This does not mean that it is up to the relatives to decide. The likely benefits from the treatment will also be considered. If a patient decides that they do not want to have dialysis, and makes that decision in a rational manner after discussion and thought, it is appropriate to be supportive of their decision.

Resources should be available to support patients in these circumstances. Continuing involvement of the renal team is almost always appropriate.