What does Conservative Care look like for ESRD?

[kickingandscreaming]

Thank you, Beckums.  I'm sorry about all the losses you've endured.  I have gone through long stretches of that kind of thing myself and know how hard it is.  There was a period, some years ago when I lost my husband, my 2 dogs, my mother, my financial security and my profession.  But I was younger then and didn't have this disease at the time. Now, at 74, and with this foul disease, my prospects for a "restart" after another major loss will be much less.  A lot will depend on how I'm doing with PD at the time.  But I do have a sense that my " work is done," and that I would be overstaying my welcome (and usefulness) on the planet by stretching out my lifespan.

I appreciate your words and description of hospice for ESRD.  Isn't there such a thing as sedation to make one unaware of all those terrible symptoms ?  I have no desire to be awake through my death. I'd much prefer to be "out of it."

I realize my terminology in my OP was incorrect.  Conservative care is what is offered if someone refuses dialysis in the first place.  Palliative/hospice care is what it's called after someone has been on dialysis and then refuses to continue. 

I have often wondered whether it is possible to take advantage of the Dr. assisted suicide that is now legal and available in some states (altho not my Massachusetts).  But they do have it in VT and I could move there or visit--if that's possible-- and die there.  Anyone know what the rules are about that?

[beckums70]

Many hospice patients are indeed very sedated at the end with pain medications (usually morphine based) and/or medications to treat anxiety.

I didn't mention before, but I also work with seniors and have done so in some capacity my whole career.  I used to think that people in their 70's probably had little to offer the world anymore--that was my youthful ignorance.  I have learned and benefited so much in my lifetime from all the varied personalities and life-stories of the elders with whom I've had the pleasure of working.  I am now of the belief that we are never too old to learn, grow and contribute to the world around us. 

This disease challenges us all with limiting beliefs about ourselves, our abilities and our purpose in life.  I truly understand that.  I am 46, so not a spring chicken but not yet an elder.  I already struggle sometimes with believing in the "usefulness" of my stay here on Earth.  I really do empathize with you. 

I'm also very proud of you for opting to go with PD.  It is much easier on the body, especially in someone of your age.  Most people in their 70's or older who opt for hemodialysis later regret starting dialysis at all.  If you are doing well on PD, that's a good thing.  If, however you still feel like crap all the time, I completely understand why you'd want to stop.  It is a highly personal decision and many seniors choose to stop so they can have a better quality of life for the rest of the time they have left.  In a similar situation I'd probably do the same.  To me quality of life is far more valuable than quantity.

I don't know about assisted suicide in your state.  I have known of people who moved, to another state to take advantage of the laws there.  The drawback of that, for many, would be having to weather those last days and moments away from home and what is familiar to you.

If you do decide to cease dialysis, please take time to make sure it's what you really want to do.  You can go on hospice and then change your mind later.  Signing up for hospice is not necessarily a death sentence and you aren't obligated to stick with it if you change your mind and want to go back to dialysis.  They really do all they can to make you as comfortable as possible.  Hospice utilizes an interdisciplinary team to address all the needs of the patient and family, not just the physical ones. You'd have a social worker, chaplain, volunteer services. a nursing assistant, nurse and hospice medical director to help you.

I wish you and your dog the best,, and hope you both survive this tough time.