Dialysis Patients’ Very Different Life or Death Choices

Illustration by Barbara Hranilovich. All rights reserved.

Illustration by Barbara Hranilovich. All rights reserved.

This month’s Reflections essay is called “Sitting with Death.” The subtitle provides a little context: A social worker on a dialysis unit bears witness to patients’ life or death choices. Despite the sad stories the author tells, this remembrance doesn’t leave a reader feeling disheartened.

Retired social worker Linda Converse writes that starting work at a dialysis center was at first daunting. How could she talk to patients about such an ultimate choice as whether or not to give up dialysis?

But over time she began to understand that there was usually no right answer. For each person, there was a different personal algorithm that guided the choice, one based on such factors as quality of life, obligations to loved ones, values, and much else. Writes Converse:

I’ll never forget some of the patients who chose to stop dialysis, nor will I forget those who chose to hold on for as long as possible. There was no consistent logic when it came to an individual’s choice. What one person considered an impossible quality of life, another wouldn’t.

The glimpses of patient stories she gives illustrate this observation vividly. This is also a story of the author’s gradual shift in understanding to a kind of acceptance. It never got easier for her to do the work, but she writes: “In the end, I learned to ‘sit with death,’ instead of wanting to avoid it.”

Take a few moments and read this essay if you have the time, and let us know what you think.

2016-12-05T08:57:58+00:00 December 5th, 2016|patient engagement, patient experience|0 Comments

About the Author:

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

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