Opinions of elderly people on treatment for end-stage renal disease.
BACKGROUND
As more people survive into old age, a greater number are becoming eligible for dialysis treatment for end-stage renal failure. In the UK the elderly have previously been excluded from treatment programmes, and continuing financial constraints are unlikely to improve this situation. There are few data on the views of elderly subjects on renal replacement treatment. We have, therefore, explored the views of elderly subjects in this study.


METHODS
50 subjects were selected from hospital geriatric wards and nursing homes. A short clinical vignette about a 75-year-old patient with renal failure was presented, and the subjects were asked to give their opinion on choices made by the patient to different treatment options. The subjects were then asked what choice they would make if in the same situation. They were asked what level of symptoms they would tolerate and for their views on cost and treatment allocation. Important contributors to quality of life were also determined for each subject using visual analogue scales.


RESULTS
84% of the subjects would choose dialysis treatment, and 78% of all elderly would attend hospital as necessary, if their symptoms could be relieved. 54% of the in-patient elderly and 83.3% of nursing home elderly even when physically disabled and living in a nursing home would want dialysis for end-stage renal failure. 74% of all elderly preferred to have home dialysis treatment. Only 36% of the subjects thought cost was important when allocating dialysis to the elderly. Being independent and free from major symptoms was regarded as important for a good quality of life.


CONCLUSIONS
In this survey, elderly subjects wanted dialysis treatment. Neither age nor cost were considered important determinants for resource allocation. Symptom relief and maintaining independence were considered the main goals of treatment.
Ahmed
S
S
University Department of Geriatric Medicine, Hope Hospital, Salford, UK.
Addicott
C
C
Qureshi
M
M
Pendleton
N
N
Clague
J E
JE
Horan
M A
MA
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D013677:Medical Laboratory Science; D017060:Patient Satisfaction; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D011795:Surveys and Questionnaires