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
Nic Cunningham
Senior Programme Manager
Supportive care in London
As the UK population ages, the older, frailer renal population is increasing. Evidence suggests that if patients are aged over 80 or over 65 years with significant co-morbidity, they may not gain either more years of life or better quality of life with kidney replacement therapies (KRT-dialysis or transplant). These patients may prefer a medically based supportive care pathway requiring a combination of specialist skills in the care of the older person, frailty and renal medicine. For those who progress to KRT, parallel frailty care can improve quality of life, optimise symptoms and reduce hospital bed days. All renal patients could benefit from good supportive care.
Aims and objectives of the group:
Aims and Objectives
Aims
-
- 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
-
- Support London ICS’ implementation, evaluation and continued future funding of the Renal 3Ps Frailty and Supportive Care projects
- 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 booklets and posters
- Integrate patients’ insights into our work by obtaining feedback from:
– Wider group of kidney patients to understand diverse views on supportive care
– Patients who are formally on the SC pathway and on dialysis
– 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 use of supportive care in all London’s renal units in London for those considering and enacting dialysis withdrawal
- 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