Supportive Care
Purpose
Supportive care ensures that people with kidney disease who are older and frailer get care that is as good as those who are younger and fitter. It does not have to be the same care but it does need to be the best of the right care for this group of patients.
This priority work with help develop services and resources to enhance and maintain the best quality of life possible for those choosing maximal supportive care without dialysis, as well as those choosing to have dialysis.
LKN Leads
Katie Vinen
Clinical Co-Chair
David Evans
Clinical Co-Chair
Heather Brown
Clinical Co-Chair
Linda Tarm
Senior Project Manager
Supportive care in London
As the demographics of our population change a greater number of patients cared for by kidney services will be older, frailer and often have complex and multiple other medical problems. At present these patients are often managed in the same way as younger patients with focus on biochemical targets, and complex dialysis regimes rather than the holistic care of the whole patient.
This can result in patients with many unmet needs, poor symptom control and frailty. Issues may arise such as poor mobility or memory problems which if addressed correctly can improve quality of life.
An audit in south London showed that health care professionals lack confidence in how to best offer supportive care pathways to patients. They wanted more access to training and education to help them.
Aims and objectives of the group:
Aims and Objectives
Aims
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- Supportive Care services enhance and maintain the best quality of life possible for all those choosing supportive care with or without dialysis, regardless of place of care.
- Older and/or frailer patients get care which is as good as those who are younger and fitter.
- All patients are supported, through shared decision making, to make the right treatment choice for them.
Objectives
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- Support implementation and continued future funding of the 3Ps Frailty & Supportive Care projects by working with London ICS’ through a Community of Practice.
- Create a unified and consistent data set across the 7 renal units in order to understand the relationship between the identification of frailty and subsequent actions.
- Promote and embed use of LKN patient information, e.g. booklets and posters.
- Integrate patients’ insights into our work by obtaining feedback from:
1. Wider group of kidney patients to understand diverse views on supportive care.
2. Patients who are formally on the SC pathway and on dialysis.
3. Frail patients who have geriatrician input at an Advanced Kidney Care Clinic. - Develop guidelines for common symptom control in adults living with CKD stage 5 in the community.
- Develop Dialysis Withdrawal Guidelines that enables consistent and supportive care across renal units in London for patients considering and enacting the withdrawal of dialysis.
- Support primary care to manage frail patients with advanced CKD in the community.
Completed Work
Advanced Care Planning Pathway
Supportive Care Pathway
Dialysis Withdrawal Guidelines
Other resources
Difficult Conversation Booklet for Health Care Professionals
Supportive care e-module
If you’d like to learn more about Supportive Care, follow this link
Supportive Care: Making your treatment decision
Supportive Care: Living well without dialysis