Rethinking dialysis: Giving patients choices

Catherine Burgoyne hated what was happening to her. At the age of 92, she had suddenly lost her cherished independence. A fall led to kidney failure, which led to dialysis, which led to the need to tie her wrists to the hospital bed rails.

In those days, she was often confused and would try to rip out the tube in her chest, implanted to enable dialysis. But her words and grimaces left no doubt that she could not bear the restraints, or her complete dependence — a life so different from what she had known just weeks earlier.

Burgoyne had chosen her nephew and his wife, Robert and Nancy Tucker, to make health care decisions if she could not. Now, her nephew spent hours at her side, distraught over her misery, anguished by the choice before him. Her hands could be freed if dialysis stopped. But dialysis was keeping her alive.

She was among the growing number of very old and very sick people who end up on dialysis, a procedure that filters toxins and other substances from the blood.

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