Comprehensive conservative care

Commencing treatment for end-stage kidney disease can be an emotional time. The experience of dialysis can be overwhelming, too.

For these reasons, it's worth discussing options with your healthcare team as soon as you can. This way, feelings and strong family opinions won't cloud your judgement when the time to decide comes.

If you choose to opt-out of dialysis and explore comprehensive conservative care, that's okay. There are several reasons why comprehensive conservative care may appeal to you:

• whether on a spiritual, cultural, or personal level, you believe the burden of dialysis outweighs the benefits
• you do not want the tests, procedures and appointments associated with ongoing dialysis treatment
• you are frail, elderly, or have other medical conditions - in which case dialysis is not guaranteed to improve your quality of life. You may live just as long with comprehensive conservative care as with dialysis treatment.

If you are already undergoing dialysis, you may choose to change over to comprehensive conservative care. No matter your reasons for not wanting dialysis, it is your right to choose.

While the decision is up to you, it can be helpful to involve family members, close friends, a social worker, a counsellor or spiritual adviser, and your doctor before making a decision.

'Advance care planning' is a process you will undertake with your healthcare team, family and loved ones. Together, you will develop a plan that formally documents your wishes in regard to your end-of-life care.

It's ideal to have this in place if you're over 65 or have any other conditions that may impact your quality of life during kidney disease treatment. The process can involve:

• writing a will
• having discussions about your wishes with your family and your doctor
• appointing a substitute decision maker
• telling people about your end-of-life preferences (how you would like to be cared for).

It is also advisable to involve local palliative care services, earlier rather than later, as they can help manage your symptoms and other end-of-life planning for you and your family. Some people access palliative care well before the end of life in order to reduce their symptoms.

For more information, we encourage you to browse the resources below.

Some health services offer an initiative called ‘Supportive care’ that complements your kidney failure treatment. Supportive care aims to help you live as well as possible with kidney failure, no matter what treatment you choose. It is patient-centred and focused on reducing pain and suffering and improving your quality of life. Your healthcare team will be able to provide you with more information about support offered in your local area.

For more information, we encourage you to browse the resources listed below.