Medical management and palliative care
You may choose not to start dialysis or get a kidney transplant. In some cases, people who start dialysis decide to stop. Supportive care and treatment to manage your symptoms, without doing dialysis or having a kidney transplant, is called medical management. It is important to understand that supportive care and treatment to manage symptoms are not treatments for kidney failure and will not keep you alive. These treatments will help you live as comfortably as possible until your body can no longer function.
How long will I live if I choose medical management?
How long you will live depends on many things. Every person is different. Nobody can give you a definite answer to this question, but your doctor will help you stay as healthy as possible.
What do I need to do to get ready for medical management?
Talk with your doctor before you decide on medical management. Your doctor can help you learn what to expect.
Work with your doctor to create an advance directive. This is a care plan that explains what treatments you do and do not want at the end of your life. Make sure this plan is in writing (some states even have forms to help). Keep a copy of your plan at home, in an easy-to-find place, and discuss it with your family.
Ask your doctor about hospice care. Most people who choose medical management are able to get hospice care. The goal of hospice care is to keep you comfortable and improve your quality of life while you are dying. Hospice care can:
- Provide care and help you manage symptoms
- Help you have the best possible quality of life
- Offer support for you and your family
- Take place at your home, a nursing home or a hospice center
What if I am not sure about starting dialysis?
If you are not sure whether to start dialysis, ask your doctor about trying dialysis for a set amount of time. This is called a time-limited trial.
You and your doctor will decide on a treatment plan and goals for the trial. At the end of the trial, decide with your doctor if dialysis helped you meet your goals and whether you want to continue.