'Mandatory' modality video

[LifeOnHold]

We just had our 'mandatory' modality video... they come around with a questionnaire and you're supposed to watch a video about the different types of dialysis plus the option of transplant.  I've been through all of them so I don't have to watch it.

But I have been thinking that making these elderly people watch a video that talks about transplantation is pretty cruel when you consider that all of them are over the maximum age for a transplant... it just seems like they're rubbing in the fact that these patients are stuck here until they die.  I'm going to bring that up the next time I talk to my social worker.

[Epoman]

Wow that is cruel, I can't believe they make even the older people watch it. I guess it's because they have to cover their ass by proving they have let people know all their options. You should bring it up to the social worker, I would if they did that at Davita.

[LifeOnHold]

I think it would be better if they had a video with just the hemo and PD options, with a seperate transplant video that individual patients could borrow... we have very few transplant-eligible patients, so I don't understand the necessity of making the majority of the patients watch it.  There's enough depressing crap at dialysis already, we don't need to be reminded of an option that we can't choose.

[dialysta]

The reason your center showed the video is they are required by the Medicare Conditions of Coverage to inform everyone of their treatment options. There is no upper age limit for renal transplantation although it is important that whenever a kidney transplant is considered, the potential benefits outweigh the disadvantages. The transplant operation and the subsequent treatment are both relatively arduous and therefore a patient needs to be fit enough to withstand the entire process. Where patients are very frail, or have significant medical problems, the risks of undergoing a transplant may be too great and it is less likely that transplantation will be considered an option for them. The decision on the appropriateness of renal transplantation is made by the individual concerned in consultation with their doctors.

[Epoman]

The reason your center showed the video is they are required by the Medicare Conditions of Coverage to inform everyone of their treatment options. There is no upper age limit for renal transplantation although it is important that whenever a kidney transplant is considered, the potential benefits outweigh the disadvantages. The transplant operation and the subsequent treatment are both relatively arduous and therefore a patient needs to be fit enough to withstand the entire process. Where patients are very frail, or have significant medical problems, the risks of undergoing a transplant may be too great and it is less likely that transplantation will be considered an option for them. The decision on the appropriateness of renal transplantation is made by the individual concerned in consultation with their doctors.

Right! like I said they are covering their asses. But is it really necessary to show the video to a 80+ year old fragile patient with numerous other medical problems? The video shows how you will fill better and get off dialysis. Plus I think maybe your wrong about "no upper age limit" because I have understood after a certain age they won't give a transplant.

But on a different note thanks for your reply and for joining the forum, welcome. I hope to see you post more and help us make this a great (busy) forum.

[LifeOnHold]

I was told that 70 is the cut-off age for transplant... it was 65 but we had a few patients who were doing so poorly on reuse dialysis that their docs thought it would be better for them to take a chance on a transplant.   But since we stopped reuse, we haven't had anyone older than their early 60's get a kidney.

Most of the patients in my unit didn't really pay attention to the video anyway, because a lot of them are on their 'last chance' grafts and are no longer candidates for PD or transplant.  I am just saying that for patients like these, who are already painfully aware of their limited options, this video is just another aggravation.

[angieskidney]

the problem with units is they are so busy trying to cover their asses that they don't stop to think about how it would feel to a patient. They don't know what it is like to be in the patients shoes.

[Hawkeye]

the problem with units is they are so busy trying to cover their asses that they don't stop to think about how it would feel to a patient. They don't know what it is like to be in the patients shoes.

The reason your center showed the video is they are required by the Medicare Conditions of Coverage to inform everyone of their treatment options. There is no upper age limit for renal transplantation although it is important that whenever a kidney transplant is considered, the potential benefits outweigh the disadvantages. The transplant operation and the subsequent treatment are both relatively arduous and therefore a patient needs to be fit enough to withstand the entire process. Where patients are very frail, or have significant medical problems, the risks of undergoing a transplant may be too great and it is less likely that transplantation will be considered an option for them. The decision on the appropriateness of renal transplantation is made by the individual concerned in consultation with their doctors.

Right! like I said they are covering their asses. But is it really necessary to show the video to a 80+ year old fragile patient with numerous other medical problems? The video shows how you will fill better and get off dialysis. Plus I think maybe your wrong about "no upper age limit" because I have understood after a certain age they won't give a transplant.

Yes your both right the dialysis clinics are "covering their asses" by showing these videos to one and all, but it's not by choice.  If the videos aren't shown and the forms aren't signed then the clinics can lose their medicare and medicaid backing.  Without that there is no clinic.  Most patients (none that I have ever seen) can afford to pay for their own treatment so this is who pays, therefore they make the rules.  It may be a cruel thing to do, but in order to operate within the guidelines provided to us it has to been done.  I agree that it sucks and that it is an evil thing, but unfortunately it is a necessary evil.