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My father has now been diagnosed with kidney failure. He is refusing dialysis ans a catheter at home. Hospice was suggested. He has COPD, diabetes and early stages of dementia. Has a good enough good days, he refuses a POA. I have been helping take care of him, but now I’m wondering what this kidney failure means. Has anyone have any experience with this? When I hear the word hospice, I hear end of life. Help!

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I have advanced kidney failure and have been on dialysis for two years. I am 66 and an insulin dependent diabetic. I have dialysis five days a week and each treatment is about four hours long. I have my own dialysis equipment so I don't have to go to a center for treatment and I have my own dialysis tech to do my treatment. Having to be transported to a center for treatment would add more time onto the process. Dialysis is very tiring even without having to be transported to a center. There will come a day when I no longer want to do to do treatment and I will make that choice. When I stop dialysis I will die within a week or two. Dialysis is a personal decision. With dementia I think it would be difficult for him, and with that diagnosis POA may not be able to sign and you will have to go to court. Kidney failure is not a painful way to die compared to some illnesses. I would seek Hospice. It's not a death sentence. These are his choices to make. My own dad died of kidney and liver failure. He chose when to stop treatment and we went along with his decision.
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JoAnn29 Feb 2023
So sorry for your problem. I had two friends one a juvenile diabetic the other type II. Both chose to discontinue dialysis and passed within 2 weeks.
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I'm sorry you're having to deal with this.

If dad needs dialysis and is refusing it, he is going to die, sooner, rather than later.

He will not appoint a POA? Then there is nothing you CAN do.

Hospice can mean EOL it usually does, but it also means CARE and DIGNITY. He is going to get sick, not doing dialysis and I expect that's an unpleasant way to go.

You have to have SOME kidney function to live. Doesn't he understand this? I cannot imagine his Drs haven't spoken to him about it.

I'm sorry for my bluntness. But that's the way it is.
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If he does not want further care, that is his right, and might be for the best. If I were older with a lot of health issues, I would certainly be asking for hospice. I don't blame him or see anything wrong with letting nature take its course. He will be kept comfortable and not artificially kept alive for what will probably not be a very meaningful existence, especially as his diseases progress.

I know this is hard but you're going to have to come to terms with this quickly so you can be there to support your dad.

Best of luck.
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Yes, you are looking at end of life if your father has been told he needs dialysis in order to live. You need to do some internet online simple research on kidney dialysis.
You don't mention your Dad's age. I am 80, and a retired RN. For several decades now I have had written in my advanced directive that I will not accept kidney dialysis, even briefly. To my mind the cost of same is not worth the extra limited time to live with the side effects. Your father would have to spend at least three days a week in dialysis for about half the day. He would be exhausted and in need of dialysis prior to it, and depleted after it. He would be on a limited diet and prone to infection from his implanted dialysis catheter. To me it is no way to buy a bit more time and I would choose Hospice and the end of life care.
Without dialysis your Father has been told now that his kidneys are in failure and cannot rid his body of toxins. Many live much longer than predicted without dialysis and many pass very quickly indeed; much of that depends on the "numbers" the doc is seeing now in lab tests.
So yes, you are now facing end of life care; I am very sorry but that is the truth. Hospice will ease your father's passing; there will no longer be treatments other than of things involving comfort care.
I agree with your father's choice and it would be my own. Support him in his choice.
He need not have a POA if he doesn't wish one, but it is time for him to tell everyone where any will and important papers are.
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My mother died of kidney failure after years of health issues. Luckily, she had no dementia, and I was able to talk to her about what she wanted, and what life with failing kidneys would look like. She said she didn't want to go through that after all she'd been through (she was basically an invalid at that point). We moved her to a lovely hospice where she got to spend her last days with family and friends (especially the grandchildren, who were freaked out by the hospital, but felt more comfortable spending time with her doing the things they always did — showing her pictures they drew, that kind of thing — in the hospice)
End of life is not the worst thing in the world when someone is very sick. If you can provide a quality end of life, in a hospice, you will be at peace and so will your father.
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With a dementia diagnosis he cannot sign any legal paperwork such as a POA, it’s too late for that. If he’s refusing treatment, that is his right, he has a lot of hard conditions to deal with, it’s understandable why he might feel as he does. Sometimes elders simply get to a place of having had enough, my dad certainly did. He used to tell me often that he loved his family and friends, but it wasn’t enough anymore in the face of all the constant medical issues to want to be here anymore. That was so very hard to hear, but I’d always say that I understood. Hospice was an enormous help to us. It’s very true that it is basically end of life care, and that’s difficult to swallow, but we all have an end coming, and having help to guide during the process is important. Hospice doesn’t mean death is coming soon or immediately. And it DOES NOT kill people. Their services provide home health supplies in abundance, nurses to check in a couple of times a week, aides for help in bathing, meds for comfort, and loads of wise counsel. They were a godsend for us. I hope you’ll look into it. I’m sorry you’re facing this time with your dad and I wish you both peace
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It is OK. Unfortunately I know some of this already. So no apologies for the bluntness. Yes I believe he gets it, but he doesn’t care anymore. It’s just hard. I am an only child, I lost my mother when I was young, my father was a wonderful man, still is, he did a great job of helping me and I just feel so it’s my turn to help them. He was always my hero! I guess the question I’m looking for a time, how much? Does anyone know
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againx100 Dec 2022
His doctors could be the best guessers at how much time he might have left but even that is just a guess. So I guess it's a "hope for the best but expect the worst" kind of situation. Try to help him get all his final wishes and arrangements taken care of, if they're not already done. I would guess that hospice would help with things like that.

At least you will have great memories of the man you describe as wonderful. Not everyone can say that about their parents!
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My boyfriend just got off dialysis after 7 months the doctor ordered the take off they just took out his catheter yesterday all blood tests and his other test are above goal peeing is all great and he happy he off it. but we still have to do blood testing and scans for now to see how he doing and make sure he doing good so day by day is our goal this is he's first day being off completely. Been threw alot with him so happy for him. He died twice in operation room but they bring him back 2 times it was really complicated heart attack then something else had too put stents in his heart and he has 7 other stents everywhere else. The doctors said it was a miracle he ever made it back so many things happened to get to this point and to get taken off dialysis is a miracle in it self but we are still watch for any sign of anything for quite awhile so prayers everything goes smoothly for us. He has followed everything they told him to do diet, water intake, sodium levels and other level he has to be at are all above level it was hard for us and so uncomfortable for him but he was a champion 🏆🥇 more then I expected. all doctor visits he went to and he started at 3 times a week for quite awhile at dialysis then he went to 2 times a week for most of the time, then one day doctor put him one a week for the rest of the time then then off completely for 4 weeks but keep getting blood tests and some other tests done to see where he was at and now this is he's first day off completely tube out of his neck and chest and free of dialysis but doctors are still watch everything
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You don't say how old Dad is.

I had 3 friends who were diabetics and all had kidney failure. One a juvenile diabetic the other 2 diabetes II. The juvenile one could not do conventional dialysis because years of being diabetic effected her veins. Her and one other did the peritoneal dialysis. The other on reg dialysis. All chose to discontinue dialysis. All passed within 2 weeks. Two in early 60s, one was 70.

I would wonder if Dad has Dementia. The toxins produced by the kidneys have dementia type symptoms.

Hard decision but its Dads decision.
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