| dc.description.abstract | Background: In Chile there are 22,310 people in Chronic Hemodialysis (CHD), 53% of them older adults (OA). Shared decision-making and
advance directives (AD) are especially important in OA with end-stage
chronic renal failure, since they have greater levels of disability, morbidity
and mortality, raising doubts about the benefit of therapy. Aims: To understand the experience in decision making and explore ways to express
AD, in OA in CHD. Material and Methods: A qualitative phenomenological study, performing 12 in-depth interviews to OA who had been
at CHD for at least one year. Results: The analysis revealed four broad
comprehensive categories, two related to participation in the decision to
enter CHD, namely the experience of subjects as spectators and their lack
of interest for decision support and two referred to the expression of AD,
namely the difficulty in facing their own finitude and resistance to express
AD. Conclusions: There is little participation of older adults in the decision
about their admission to dialysis therapy, and once they enter the CHD
program they are not prepared to discuss AD in general, nor an eventual
suspension of dialysis in particular. | |
