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Aster's avatar

A 91 year old lady is having dialysis after kidney stone removal. Thoughts?

Asked by Aster (15490 points ) December 10th, 2012

How do you feel about a 91 year old woman having kidney stones removed followed by dialysis? Is this a decent quality of life? She is living at a facility that allows them to perform it right there in the building.

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13 Answers

WestRiverrat's avatar

It is her choice. I personally would not want to be tied to a dialysis machine at any age.
But if she wants dialysis it should not be denied her just because of her age. After 91 years she has earned the right to make that decision without any interference from anyone.

Aster's avatar

Thank you. Her daughter encouraged her. The hospital let her go home right after her kidney stone removal but she fainted on the way out and they put her in a room. After a couple of weeks they decided she needed dialysis.
I feel that most people , or at least women, tend to go along with what doctors suggest. It would be, I think, a difficult decision to make on your own.

Coloma's avatar

I agree with @WestRiverrat It wouldn’t be my choice, especially considering that renal failure is the most common death in advanced age for people and animals if nothing else takes you down first.
Her choice though.

augustlan's avatar

Dialysis, especially the kind that is done in place, is not so bad that I’d rather die than have it. My bio-father was on dialysis for quite a while (he was on the transplant list, but never got a new kidney), and it allowed him to enjoy the rest of the life he had left. There is a chance I will need it someday (I inherited his kidney disease), and I certainly plan to do it if it comes down to it.

janbb's avatar

My MIL and her kids decided she wouldn’t do it when faced with a similar choice. Each to his own.

Simone_De_Beauvoir's avatar

Not enough details. I think that if she wants the dialysis and is able to afford it, then why not?

hearkat's avatar

One can not make such decisions based on such limited information. Ethically, we can not use chronological age alone as a determining factor on whether or how we treat the patient. I know some very vibrant 90-somethings and some rather lifeless 40-somethings. Physicians are sworn to fight disease and death, although conversations about quality of life and palliative care are becoming more common. I have patients tell me they don’t want hearing aids because they’re over 80. To which I reply, “Tomorrow isn’t promised to anyone and you could outlive me. But being able to hear better will help you make the most of whatever time you have left, which your loved-ones will also appreciate.”

I’ve seen people that cling desperately to life and put themselves through all sorts of misery to fight death, and I’ve seen others that serenely accept their condition and choose not to poison themselves in hopes of killing the disease first. None of us can imagine what that is like until the day we have to make that decision for ourselves. If the woman in your question feels that dialysis is the best option for her (and who knows what else was discussed between her and her doctors), then so be it. If she gets to a point where she feels that it is too much for her, then she can revisit her options with her physicians and choose another option.

Mariah's avatar

It’s not my place to say that someone should give up more readily because of age. Sure, for many of is, if we were 91 and had to go on dialysis, we would probably decide to give in. She chose differently and that’s completely fine.

Especially because the dialysis can be done where she lives (so maybe even while she is asleep at night), this does not necessarily mean her quality of life has dropped to zero. That is up for her to decide.

burntbonez's avatar

A question. Does it make a difference if she can afford to pay for it herself through private insurance, or whether we all pay for it since she is on Medicare?

Mariah's avatar

@burntbonez My stance doesn’t change. I’d consider it completely fucked if we collectively decided there was some cut-off age where we don’t care about people’s right to life anymore.

bob_'s avatar

Dying’s no picnic, yo.

augustlan's avatar

@burntbonez My stance wouldn’t change either.

hearkat's avatar

@burntbonez- At 91, she might not have paid into Medicare, but her spouse did. Nowadays, most people work and pay into Medicare. The problem is that Medicare didn’t count on so many people living so long after retirement. Thus, it is underfunded. But the healthcare issues of the USA are for another discussion…
My decision does not change whether she is self-pay, has private insurance, MediCare(for the elderly and/or disabled), MedicAid (public assistance health care), or charity care… if a patient and her health care team decide that dialysis is an option for her, then I’m ok with her going for it.

The only time I question an aggressive life-prolonging medical approach is when the patient is in prison serving a life sentence… when someone has wronged another member (or members) of society that it was decided to lock them away for as long as that live, I don’t think there should be aggressive medical care at the expense of the taxpayers. Pain management I’m OK with, but I’m sure others would say that if they caused pain to others, they deserve to suffer as well.

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