Transplant Failure

[smartcookie]

Hi everyone!  I got a new patient today in the clinic.  He got a transplant several years ago and it has recently failed.  He probably is not eligible for another transplant due to age and a recent amputation.  I feel awful for him.  I asked him how he was handling everything, and he just said that he is going to do what he has to do.  Do you have any advice for me as his social worker?   What sort of help can I be emotionally and psychologically for him?  I figure y'all know better than anyone how I should handle this and I want to be as sensitive yet helpful as possible.  Thanks!

[Simon Dog]

Help him find the best form of dialysis that works for him.    It's all to easy for MDs to make assumptions about hemo vs. pd. vs home hemo, that patients are often steered in a direction without any serious discussion as to what would work best with their lives.

[PrimeTimer]

I think it's great that you are driven to help people. Let your new patient know that this is not just a job for you so they don't feel like another number. For me, just hearing that goes a long ways.   

Just off the top of my head, I would find out:

-If he has any financial worries, hopefully you can help line him up the help he needs with any of that.
-Since he's a recent amputee, while he does in-center dialysis perhaps he'd like to be on a shift with other amputees to relate with.
-If it's a possibility in his future, I'd talk prosthetics, electric wheelchairs or scooters with him. My guess is that he'd like to be anywhere but laying in a bed. Talk mobility!
-Find out his interests and/or what he feels he needs to be able to do and then perhaps help him do some brainstorming for ideas on how to continue doing those things. Again, talk mobility!

Good luck. You're an angel. 

[Rerun]

It is really hard coming off a transplant and going back to dialysis.  He must want to live, so go from there.  Ask the staff to be super nice and understating to him.  Extra attention for a little while until he comes to terms with this lifestyle again.

Tell him about our site, unless we need to keep it our little secret.    

[smartcookie]

Thanks, everyone! I will have to ask if he has internet access. I have a lot of patients who have no internet access due to being in a poor area. I have told a couple of patients about this site, but no one has signed up yet. I would love for some of my young homebound patients to sign up since they have limited social support. I am going to ask my clinic manager about putting a flyer in the lobby as well. 

[PrimeTimer]

Thanks, everyone! I will have to ask if he has internet access. I have a lot of patients who have no internet access due to being in a poor area. I have told a couple of patients about this site, but no one has signed up yet. I would love for some of my young homebound patients to sign up since they have limited social support. I am going to ask my clinic manager about putting a flyer in the lobby as well. 

That's an excellent idea! They will never feel alone here and with all the info that can be learned on this site, it's empowering. 

[Whamo]

   I am glad you are caring about your patients.  My wife is a nurse, well, a patient manager, now, and she's the same way.  I am so lucky to have a wife like her.