Do dialysis patients have an altered biological clock?

[Chisca, RN]

I have often been amazed at the time distortion some dialysis patients have when they are present for their treatments. I have been accused of setting clocks back, altering clocks on the wall, and lengthening treatment times. These patients are deadly serious and are quite angry. A new study shows that depressed individuals have an altered biological clock and I do think a large segment of the dialysis population is clinically depressed. Could this possibly be an explanation for the distorted sense of time some patients experience?

http://www.guardian.co.uk/science/2013/jan/01/psychology-time-perception-awareness-research

[NurseRies, BSN, RN]

Haha that's kind of hilarious. I think what some patients don't understand is that if they run four hours, the online clearance test occurs about 5 times probably, every time the online clearance test occurs, it pauses the time clock. So that adds about 5 minutes, not to mention also everytime the machine alarms it interrupts treatment, adding more time. Then some of these people start the clock from their appointment time. If they walk through the door at 11, they should be finished right at 3? Right? Wrong! I see the same things too, but I think these people just don't understand their actual treatment clock. Just because they start at 10, doesn't mean they're done at 2. Maybe they're sense of time is a little off, but if they think you are changing the clocks on the wall, it sounds like they have more psychological problems then anything. Paranoia or maybe just lack of basic sense! Most patients understand the time fluctuations and don't complain. Of course a few are always going to be confused because they simply don't understand the concept of treatment time vs actual time.

[amoLucia]

Question - does this problem seem more common among pts coming from home settings or those that come from a LTC facility??? Esp the EARLY appointment pts?

I'm from LTC. So I question because I know that our early dialysis pts need to be awake & up really, really early so they can be ready for their transportation. That means an early breakfast and early AM care. Contrary to popular belief, nite shifts in many LTC places are not conducive to prolonged sleep opportunities. So there could well be some serious sleep deprivation issues here.

Many times I've felt sorry for my early dialysis pts - they go out soooo tired. Add advanced age and the chronic renal failure issues of cardiac, respiratory and endocrine problems. So it's little surprise to me that there might be some disorientation. Clinical depression most definitely figures in too. And then if they have any difficulties while on the machine... Just know that when they come back, all they want to do is sleep. I might guess that pts coming from home situations may have similar problems.

Just offering another perspective or rationale for your post.