Kidney disease and Dialysis - the psychosocial aspects of renal failure
Kidney disease or renal failure
Take a look into the world of an individual with kidney disease (renal failure) and dialysis, the life between the machines. It was three days before Christmas, two years ago, that I became acquainted with this monster. All festivities came to a crashing halt as we heard that a loved one, a young man of eighteen was in the clutches of the disease.
A simple description of Renal failure
Chronic kidney disease and acute renal failure cause
the kidneys to lose their ability to filter and remove waste and excess fluid
from the body. Hemodialysis or Kidney dialysis is a process that uses a man-made
membrane (dialyzer) to do the work of the kidney. The patient is connected
to dialyzer or the dialysis machine by tubes attached to their blood vessels. Blood is pumped from the
patient’s body into the dialyzer, where toxic waste and excess fluid are filtered
out from the blood. The filtered blood is then pumped back into the body giving
the patient a little comfort for a few days
until the next visit. This process may have to be repeated two to three times a
week and takes about 3-4 hours each time.
Stress associated with Kidney disease
Now with the brief description of renal failure and dialysis treatment in place, let me take you into the mind of a person tied to the dialysis machine for life. I met this young man whom I offered to take under my roof and provide care for a month. I met a young ghost to say the least. He was six foot three, a hunk of a man, who in a span of six months looked much shorter, shriveled up and much older than his eighteen years.
This is not the story of one person, over the years I met a few other young people with the same disease. I noticed that the marked change in their physical appearance caused them much anxiety. These changes in appearance brought along with it a certain amount of disturbance in identity and insecurity associated with it.
The problem of identity is compounded by their perception of the disease. Renal failure or Kidney disease is a terminal illness with no cure insight. Their acceptance of the disease and the ability to cope with life after the disease is what determines the quality of their life. The family member’s sympathetic perception of the disease (and their sympathy vs. empathy) quietly erodes their sense of independence. Sometimes the family members with the good intention of helping the individual make them invalids for life. These individuals start to look at themselves as dialysis patients rather than as a young man, a father, a student etc. They are prone to become dependant on their families to perform even their daily chores. Sometimes an individual may be in complete denial of the condition which is also risky.
Kidney failure - Social problems of Individuals
Boredom Three days at treatment and almost half a day during each visit to the hospital/ dialysis center ensure that the person’s life is locked between the machine and the house. Imagine watching your blood whirl in a tube in front of you three days a week- sounds like a terrible nightmare. Boredom at the dialysis center, just having to lie down and be able to do nothing is enough to frustrate anyone. Depression is the shadow lurking very close.
Physical discomfort such as nausea, vomiting, fatigue, muscle cramps,itching, swelling of the body especially the legs and sleep disturbances all take a toll on the individual’s personal, social and work life. Stress is very real and they are unable to do much about it.
Socializing goes out of the window with all the diet restriction. The sympathy, their presence at social gatherings bring may sometimes result in avoidance of all social contacts. Restriction on time due to treatment schedules is another culprit. Sports and other activities take a back seat as fatigue sets in. The fear of hurting self or dislodging the stent is real. Outdoor games may slowly fade from the list of activities.
Mental health aspect - Renal failure
Emotional pain is a every day reality. Fear is another constant companion. Fear of the unknown, anxiety about what next… Education stopped midway, jobs have to be resigned to give place to treatment. Hours of boredom facing them, morbid thoughts racing through their minds, all that they lived for, all ambitions seem lost. Fear of death is something that hangs around the corner as they see and hear news of the death of their new friends at the hospital. Hopelessness steps in, as treatment is only maintenance, with no chance of cure in sight. Waiting for a donor or a cadaver transplant and the fear of the body not accepting the new organ is also heart grinding.
Financial burden increases as treatment is expensive. The family’s economic resources are strained to the maximum extent possible. It may cause a lot of stress not only for the individual but also on the family. If the individual is single, with no family support, the individual has to endure a high level of stress.
Kidney failure - Help improve quality of life
One needs to be empathetic and not sympathetic.
Being supportive and encouraging them to do as much as they can, realistically, would be beneficial for the person.
Motivating these individuals to socialize with other healthy individuals with an active life style is important.
Helping them to control thought life and take charge of their life would be a great help.
Enabling them to follow their passion (that does not need much exertion) that will help them earn, as well as keep their minds actively and creatively involved, is a great stress buster.
Care to educate them to strictly follow diet restriction and making their diet visually and tastefully enjoyable will benefit their physical well being.
Engaging them in some light physical activity is also beneficial.
Spiritual well being is a part of heath as defined by the WHO, so being actively involved in spiritual activities will be another plus. Studies prove that faith and religious beliefs enable individuals cope better.
Financial help is always welcome for such an individual.
Helping others individuals with similar problems and focusing on unfortunate others is a sure fire way of keeping the mind actively away from morbid thoughts; it may help regain one’s sense of self worth.
