Research issues in Elderly patients: gaps in knowledge and suggested directions.

Abstract

Concentration of research is recommended in the following areas: Prospective studies of the appropriateness, relevance, timing and sustainability of dialysis in elderly patients Health related quality of life (HRQoL) in older patients choosing not to dialyse and in those choosing to dialyse with comparison to a matched population without renal disease Methods of communication of prognosis and factors affecting decision making Models of care - comparative studies to delineate how best to deliver renal supportive care Treatment preferences amongst indigenous patients Symptom control, focussing on those areas specific to the needs of renal patients.

Engagement in decision-making and patient satisfaction: a qualitative study of older patients' perceptions of dialysis initiation and modality decisions

“…repeated needle sticks, fistula placement and maintenance, lifelong need) and prognosis. This is consistent with research showing that patients often are unprepared for dialysis [19,42,43] and may experience regret [13,44]. Many patients directly requested prognostic information and suggested that future patients be advised of prognosis.…”

“…Many patients directly requested prognostic information and suggested that future patients be advised of prognosis. Consistent with the SDM literature [45][46][47][48], patients preferred deliberative conversations with clinicians, although mostly described prescriptive interactions.…”

“…Patient engagement in decision-making is associated with better patient-centered outcomes, including quality of life and satisfaction [44,53]. We found examples of SDM when patients described choosing a dialysis modality.…”