The Experience of the Older Adult With End-Stage Renal Disease on Hemodialysis
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Background: The growth in the number of individuals with end-stage renal disease has implications in terms of both the health of individuals, especially older adults (aged 65 years and older), and the capacity of the health care system to provide adequate treatment needed by these patients. Much has been written regarding the pathophysiology of end-stage renal disease as well as how modern advances in technology have contributed to the ‘dialysis world’. However, the literature is sparse in relation to how older adults experience end-stage renal disease and the technological complexity of dialysis in their daily lives. Objective: The purpose of this study was to explore the meaning of being hemodialysis-dependent for the older adult living with end-stage renal disease. Method: A descriptive method using a qualitative interviewing approach was used. Systematic focused thematic analysis guided by the Crisis of Physical Illness conceptual model allowed for the findings to surface. Data sources included individual interviews, direct observation of participants and the hemodialysis unit, along with field notes. A purposive sample of nine participants was obtained from two different hemodialysis units, both operated by Kingston General Hospital. Data were analyzed using the Colaizzi method. Findings: Five themes were identified by the participants: The Will to Live, Recognition of a Lifetime Commitment, Learning to Live with Technology, The Yin and Yang of Dialysis, and Transcending Dialysis. Conclusions: End-stage renal disease and thrice weekly hemodialysis treatment have an impact on the daily life of older adults and their ability to cope with the changes. This study revealed that despite the restrictions of being on hemodialysis, all of the participants had the will to live and some expressed the need for further education using a variety of strategies that would meet the specific needs of this population. A more in-depth understanding of how older adults experience hemodialysis is needed to provide adequate care/resources for this special population.