Decision making among older adults in hemodialysis. A qualitative assessment

Mariá Isabel Catoni, Sofiá P. Salas, Emilio Roessler, Andrés Valdivieso, Antonio Vukusich, M. Soledad Rivera

Research output: Contribution to journalArticlepeer-review


All rights reserved. Background: In Chile there are 22,310 people in Chronic Hemodialysis (CHD), 53% of them older adults (OA). Shared decision-making and advance directives (AD) are especially important in OA with end-stage chronic renal failure, since they have greater levels of disability, morbidity and mortality, raising doubts about the benefit of therapy. Aims: To understand the experience in decision making and explore ways to express AD, in OA in CHD. Material and Methods: A qualitative phenomenological study, performing 12 in-depth interviews to OA who had been at CHD for at least one year. Results: The analysis revealed four broad comprehensive categories, two related to participation in the decision to enter CHD, namely the experience of subjects as spectators and their lack of interest for decision support and two referred to the expression of AD, namely the difficulty in facing their own finitude and resistance to express AD. Conclusions: There is little participation of older adults in the decision about their admission to dialysis therapy, and once they enter the CHD program they are not prepared to discuss AD in general, nor an eventual suspension of dialysis in particular.
Original languageAmerican English
Pages (from-to)281-287
Number of pages7
JournalRevista Medica de Chile
Issue number3
StatePublished - 1 Mar 2020


  • Advance care planning
  • Aged
  • Clinical decision-making
  • Kidney failure, chronic
  • Renal dialysis

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