Family involvement: help and frustration

DK continues on hemodialysis and has been relatively stable. His interdialytic weight gains remain excessive at times but with support, he has been able to moderate his fluid intake. His intradialytic weight loss is still restricted to 1 kg/hr. in the absence of profound objective signs of congestive heart failure. His sons have been as cooperative as they feel is possible at this time and attempt to allow him some degree of independence. They have not yet agreed to a family conference with the health care team. Although the desired behavioral changes have come slowly and in small increments, we believe that our plan is a good one. Caring for the chronically ill is always an iterative process that requires great patience and persistence.