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Melissa Wachterman Podcast: Dialysis and Hospice
This is the first in a two part series on Geriatrics, Palliative Care, and Chronic Kidney Disease.
One of our most popular GeriPal posts ever is titled, "Dying without Dialysis". That post discusses an article on the symptomatic experience of persons who decided not initiate dialysis in the setting of advanced kidney disease.
This is obviously a compelling topic, given the high prevalence of kidney disease among older adults.
Medicare policy that poses tremendous barriers to continuing dialysis while enrolling in hospice. This sets up an either-or dichotomy that leads to low rates of hospice use, and among those who use hospice, lengths of stay that are frequently 3 days or fewer.
This week, Eric and I talked with Melissa Wachterman, a physician researcher from the Dana Farber Cancer Institute and Harvard Medical School. Melissa used a national dataset of people receiving hemodialysis linked to Medicare claims for older adults who died. She found:
- 20% used hospice (compared to 48% hospice use among all Medicare decedents)
- Of those who used hospice, 42% used hospice for 3 days or fewer.
- Melissa Wachterman's article on Dialysis and Hospice, published in JAMA Internal Medicine
- Melissa's article on Dialysis patient and physician perspectives on prognosis, also in JAMA Internal Medicine
-by Alex Smith, @AlexSmithMD
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To read the transcript to this podcast, click here.
For more Annals of Long-Term Care articles, visit the homepage
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