Spiritual distress in dialysis: A case report

Douglass-Molloy, H; Law, MM; Le, B; Katz, N

Spiritual distress in dialysis: A case report

Douglass-Molloy, H Law, MM Le, B

Katz, N

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Publisher:: ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
Publication Type:: Journal Article
Citation:: Progress in Palliative Care, 2023, 31, (4), pp. 219-222
Issue Date:: 2023

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Field	Value	Language
dc.contributor.author	Douglass-Molloy, H
dc.contributor.author	Law, MM
dc.contributor.author	Le, B https://orcid.org/0000-0002-0830-4864
dc.contributor.author	Katz, N
dc.date.accessioned	2024-01-16T05:20:54Z
dc.date.available	2024-01-16T05:20:54Z
dc.date.issued	2023
dc.identifier.citation	Progress in Palliative Care, 2023, 31, (4), pp. 219-222
dc.identifier.issn	0969-9260
dc.identifier.issn	1743-291X
dc.identifier.uri	http://hdl.handle.net/10453/174595
dc.description.abstract	The dialysis cohort in Australia, as in other parts of the world, is becoming increasingly elderly and frail. The incidence of dialysis withdrawal prior to death is also increasing, often driven by clinical deterioration and/or psychosocial factors. Despite expertise in the biomedical aspects of dialysis, nephrologists may feel less equipped to explore the existential and spiritual aspects influencing a patient’s decision-making. We present the case of an elderly woman for whom dialysis became increasingly challenging and burdensome as her global condition deteriorated. Despite multiple discussions being held regarding elective cessation of dialysis the treating team was unable to progress to a decision to withdraw. Shortly before her death the patient revealed, for the first time, the key influences of her religious beliefs to the community-based palliative care team. She described a strong Catholic faith and although unafraid of death itself, she was fearful that her decision to stop dialysis would be akin to suicide and therefore a mortal sin. Her condition deteriorated before these concerns could be further explored and she died in the intensive care setting with a high level of intervention. All people have a spiritual dimension that may influence their attitudes towards death and medical decision-making. If not elucidated, it can create barriers to appropriate care, as in this patient. There are many approaches to exploring these domains including validated tools to support clinicians who have not received dedicated training.
dc.language	English
dc.publisher	ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
dc.relation.ispartof	Progress in Palliative Care
dc.relation.isbasedon	10.1080/09699260.2022.2090052
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Gerontology
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.title	Spiritual distress in dialysis: A case report
dc.type	Journal Article
utslib.citation.volume	31
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2024-01-16T05:20:53Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	31
utslib.citation.issue	4

Abstract:

The dialysis cohort in Australia, as in other parts of the world, is becoming increasingly elderly and frail. The incidence of dialysis withdrawal prior to death is also increasing, often driven by clinical deterioration and/or psychosocial factors. Despite expertise in the biomedical aspects of dialysis, nephrologists may feel less equipped to explore the existential and spiritual aspects influencing a patient’s decision-making. We present the case of an elderly woman for whom dialysis became increasingly challenging and burdensome as her global condition deteriorated. Despite multiple discussions being held regarding elective cessation of dialysis the treating team was unable to progress to a decision to withdraw. Shortly before her death the patient revealed, for the first time, the key influences of her religious beliefs to the community-based palliative care team. She described a strong Catholic faith and although unafraid of death itself, she was fearful that her decision to stop dialysis would be akin to suicide and therefore a mortal sin. Her condition deteriorated before these concerns could be further explored and she died in the intensive care setting with a high level of intervention. All people have a spiritual dimension that may influence their attitudes towards death and medical decision-making. If not elucidated, it can create barriers to appropriate care, as in this patient. There are many approaches to exploring these domains including validated tools to support clinicians who have not received dedicated training.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/174595