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The Renal Palliative Care Initiative
David M Poppel1, Lewis M Cohen, Michael J Germain
1Baystate Medical Center and Western New England Renal and Transplant Associates, Springfield, Massachusetts, USA. dmpoppel@yahoo.com
Journal of Palliative Medicine
|July 12, 2003
Summary
The Renal Palliative Care Initiative (RPCI) improves end-stage renal disease (ESRD) patient care through better symptom management and advance care planning. This program offers vital support to patients and families, enhancing quality of life during dialysis.
Area of Science:
- Nephrology
- Palliative Care
- Healthcare Management
Background:
- End-stage renal disease (ESRD) patients face high mortality and significant symptom burden.
- Existing care models often lack comprehensive palliative and advance care planning.
- Families require substantial support throughout the patient's illness and bereavement.
Purpose of the Study:
- To implement and evaluate the Renal Palliative Care Initiative (RPCI) for ESRD patients.
- To enhance symptom assessment, control, advance care planning, and palliative care.
- To provide bereavement support for families and healthcare staff.
Main Methods:
- Established the RPCI at a tertiary care hospital and affiliated dialysis clinics.
- Trained a multidisciplinary team (physicians, nurses, social workers) in palliative medicine.
- Developed and implemented innovative interventions including symptom management protocols and advance care planning.
Main Results:
- Increased completion rates of formal advance directives among ESRD patients.
- Received positive feedback from staff and families, particularly regarding annual renal memorial services.
- Demonstrated the feasibility and benefits of integrating palliative care into nephrology practice.
Conclusions:
- The RPCI offers a valuable model for improving care for ESRD patients.
- Palliative care integration can significantly enhance the quality of life for dialysis patients.
- The initiative's success supports extending palliative medicine beyond traditional cancer and AIDS care.