Forum: Respecting kidney failure patients' choice to prioritise better quality of life

The National Kidney Foundation (NKF) respects the choice made by kidney failure patients in opting for conservative care, and supports them by relieving them of the symptoms while maximising the quality of life in their final leg of life's journey (As kidney failure rises in ageing S'pore, some senior patients opt for non-dialysis care, Sept 8).

Being diagnosed with kidney failure is a devastating blow to a person's life. It is only right that patients are given the autonomy to make an informed decision on the way they want to manage kidney failure through counselling with doctors and social workers, visits to the dialysis centres and interaction with existing dialysis patients.

We must look beyond simply providing them with quality dialysis treatment. We need to focus on enabling well-being instead of merely extending survival rate.

While we provide holistic dialysis care, we must also know when to provide a patient with an alternative form of treatment and care if he does not wish to continue with dialysis.

Very often, healthcare professionals tend to focus on better disease management, clinical outcomes and positive biological markers.

However, that is not all there is to the meaning of life, which differs among individuals. We should shift our mindset to reach a balance between life extension and better quality of life.

We must understand the patient's goals and aspirations, motivation and values in life, as well as their wish to bid farewell with peace of mind. This includes allowing patients and their families to regain control and come to a consensus on how they would like to deal with the disease, as well as granting the patient's wish of dying with dignity.

Healthcare professionals must not forget their original aspirations of working in the industry, which are not only to improve health and survival outcomes, but also to ensure holistic well-being so that patients can live well and live life purposefully.

NKF's mission of giving life and hope is not just about adding years to patients' lives, but also to ensure a reasonable quality of life in the remaining time they have with their loved ones.

Tim Oei

Chief Executive Officer

National Kidney Foundation

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