For some patients approaching end stage renal failure,
dialysis may not be suitable; without dialysis end stage
renal failure becomes a terminal disease.
The Renal Palliative Care Team has been developed at
Nottingham Renal Unit as part of a multi disciplinary
palliative care programme devoted to providing specialist
quality care to patients with renal disease who are
approaching end of life, or withdrawing from dialysis. It
also provides support for patients’ families and carers.
In addition to the hospital based multi-disciplinary team,
district nurses, GPs and community matrons were all
involved in developing the service. The British Kidney
Patient Association funded the first renal palliative care
nurse specialist in the team in 2001, who went on to
develop the team.
Since implementing the service, the number of patients
who are actively on the pathway has increased from 13 in
2001 to 83 in 2007 with a total of 210 having used the
pathway in this time.
The service is now offered to renal patients who can choose
whether to have their regular review at home or in a
nephrology clinic where clinical assessments and
treatments such as intravenous iron are performed and
psychological support is given. A care pathway is
developed and this is discussed with the primary care team.
Staff within the team offer optimum end of life care
including symptom control, regular assessment, religious
and spiritual needs and psychological support. Patients
being looked after at home benefit from the same
specialist care they would receive if they attended the renal
unit without the anxiety and difficulty of attending the
clinic.
For more information on this project, please contact:
maria.fish@nuh.nhs.uk
