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Updated February 17, 2005
Baystate Medical Center conducts an innovative demonstration project to improve end-of-life care among dialysis patients in the Connecticut River Valley Region. Titled "The Renal Palliative Care Initiative," this project is improving knowledge and practice of palliative care among renal dialysis staff, challenging denial of death and dying among patients and families, and widening community and institutional roles in terminal care of dialysis patients.
Because patients receiving dialysis often have other serious illnesses, such as diabetes and heart or cerebrovascular disease, the annual death rate among dialysis patients can be as high as 25 percent. This three-year initiative provides palliative care addressing patients' comfort, as well as emotional, social and spiritual well-being, in addition to state-of-the-art nephrology care. It is also studying the project's effects on the patients' quality of life and their medical choices.
Under the direction of Lewis M. Cohen, MD, a unique collaborative of families, doctors, nurses and social workers are planning and making critical decisions concerning the patient's end-of-life care. In the process, they are developing a set of protocols for joint-care planning that includes palliative care and ethical decision-making, and offers support to patients who wish to consider if or when to stop life-extending dialysis.
Partners addressing this serious need include Western New England Renal and Transplant Associates and the VNA and Hospice of Western New England.
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Promoting Excellence in End-of-Life Care is a national program of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.