Psychosocial Complications in PD

Abstract

My uncle is 76 years of age. He has been on continuous ambulatory peritoneal dialysis (CAPD) for the past six years, and leads a very active life. During this time, he has visited Australia and been to France twice. He has at least two holidays a year in the United Kingdom, and plays the organ in his local church every Sunday. Clearly, this is a success story for peritoneal dialysis (PD), or is it?

Two weeks ago, he telephoned with real panic in his voice. Both he and my aunt had just arrived in Edinburgh for a two-week holiday with my mother. On checking his supplies, he discovered that the wrong connectors had been delivered. It was a Friday, and it would not be possible to have a further supply until the Monday. A quick trip to the CAPD unit soon resolved the problem.

So why the panic? Do this couple really cope as well as it seems? The answer has to be No. They have always led a full and active life, and admit that, by now, they should be slowing down a bit. They are, however, afraid to do so. It is only by maintaining their normal level of activity that they keep their heads above water. If they slowed down they fear CAPD would overwhelm them.

They are living a life of denial. On one level they go through the motions of treatment but, on another, they avoid facing the reality of end-stage renal failure.

At some stage in your life you will have lost something a purse, a key, or someone close to you. No matter what you lose, you go through the same psychological reaction. Whether the loss concerns part of your body or a bodily function, the same process begins.

In a 15-minute presentation, it is impossible to discuss, in any detail, the psychological effects of renal failure and its treatment, but I can at least highlight a few areas you may wish to ponder.