The information needs of older people who choose supportive care over dialysis: A case study approach

Background: Supportive care is increasingly being viewed as an appropriate alternative option to dialysis or transplantation for older people with advanced chronic kidney disease (ACKD). The purpose of this study was to explore the information needs of older people with ACKD who choose supportive care as their treatment. Methods: A case study approach using semi-structured interviews and medical case note review methods was used to explore the information needs of six older people receiving supportive care. Results: The majority of the information the participants had recalled receiving placed a greater emphasis on dialysis over supportive care. Although they did not want dialysis, they were not clear on what supportive care meant or whether they had a supportive care plan. Participants perceived they had never been given specific information about supportive care. Medical case note review revealed infrequent and non-systematic documentation in medical case notes. Conclusions: In the absence of a formal nephrology supportive care program, information may be provided in an unplanned, non-systematic approach to older people and their families who choose supportive care.