Blog Post | November 27, 2017

American Diabetes Month: Palliative Care and Management of Diabetes & Chronic Kidney Disease

Observed every November, American Diabetes Month is an important element in the American Diabetes Association’s efforts to focus our nation’s attention on the disease and the tens of millions of people affected by it.

Diabetes By The Numbers

Chronic Kidney Disease and Diabetes

As we consider the many people affected by diabetes who are coping with chronic kidney disease (CKD) and other related conditions, it’s important to also reflect on the many ways that palliative care can provide much needed support.

According to the CDC’s Chronic Kidney Disease Initiative, in the United States, diabetes and hypertension are the leading causes of kidney failure, accounting for 72 percent or about three out of four new cases. Kidney disease is the ninth leading cause of death nationwide.

Unfortunately, the number of kidney failure cases in the U.S. population has more than tripled since 1990 and is expected to grow because of an aging population and the increasing number of people with conditions, such as diabetes and high blood pressure, which place them at risk of developing CKD.

Role of palliative care

According to the National Kidney Foundation, too few patients and family caregivers are aware that palliative care can and should be offered to all people living with serious illnesses, regardless of age or stage of disease.

What is palliative care?

Palliative care is a specialized type of medical care that can help people living with CKD by alleviating pain, other symptoms and stress at the same time they are receiving treatment to cure their disease. The goal of palliative care is to improve quality of life for both the patient and the family.

How can palliative care help CKD patients?

Individuals and caregivers facing the challenges of CKD recognize the need to take special care of the body. Managing care and treatment for kidney disease can be a round-the-clock effort that can put enormous physical and emotional strain on both the patient and the family.

Here are several ways that palliative care can offer people with CKD an extra layer of support, and as recommended by the National Kidney Foundation:

Manage pain and other conditions related to CKD

Palliative care is provided alongside curative treatment. The palliative care team will work with you to provide relief from conditions related to kidney disease, including high blood pressure, heart disease, diabetes, and kidney failure

Help with communication with your other doctors and evaluating treatment options

Palliative care is a team approach to care. Palliative care can help you make critical decisions about treatment options including dialysis and kidney transplant.

The palliative care team can help patients and families understand and decide whether to go on dialysis. For those already being treated with dialysis and health is declining, palliative care specialists can help transition to managing the disease without it.

Patients eligible for a kidney transplant often turn to palliative care before, during and after their surgery. Whatever the treatment options, the palliative care team will work side-by-side with the nephrologist and/or transplant team to support the individual patient.

Explain what to expect throughout the illness

The palliative care team will spend as much time as needed to help patients and family members better understand the condition and treatments, and better communicate among themselves and with others.

Help coping with worry, stress or depression

The burden of CKD and kidney failure can be heavy – in addition to related symptoms and difficult decisions regarding care, there may be emotional, spiritual and practical concerns. Palliative care provides emotional support for both patients and their families. The palliative care team can often provide additional therapies, including massages, talk therapy, and relaxation techniques, to ease emotional and spiritual stress.

For more information about the role of palliative care and management of diabetes during the time period when individuals are approaching the end-of-life, here are some additional resources:

World Health Organization
The Diabetes Council
American Diabetes Association

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