Court ordered dialysis for psych pts .....

Farkinott, RN · May 16, 2004

The only case i know of a client receiving "involuntary" dialysis was a severely intellectually handicapped man who was getting haemodialyisis 4hr X 3 a week. a family member was required to be with him at all times as this client had no concept of the whole deal. After this poor soul had endured about half a dozen dialysis treatments a family meeting was called and the consensus was that no more dialysis was going to be of any benefit to anyone (particularly the client). The renal staff as a whole gave a sigh of relief.

Initially the family were offered dialysis as a treatment for the client but once they realised that they would have to be present for minimum 4hrs 3X week, the reality sunk in and they decline further treatment after good honest advice.

This person died a few months after ceasing treatment but at least this person died in their own home instead of a large facility.

I know of clients with mental health issues that only sporadically attend dialysis but it is up tho them. If they are in our area we only set up for them when we see them (eg eyeballing!)

It would be a tough one dialyising an acutely unwell mental health client. i don't think it would be authorised where i work due to the danger to staff and the distress to other clients (who would be present by nature of being dialysed at the same time). I can be certain that ICU dialysis would not be permitted for such a client.

Tough one

Blackcat99 · May 16, 2004

Does anyone have to chemically, and 4 point physically, restrain psych pts who are refusing to go to their dialysis treatments. You know pts who end up coming thru the ER after their family finds them unresponsive. Then they are so out of it, violent, etc. psych gets a 72 hour hold and judge orders forced dialysis. (until the pt is stable enough to realize the need for dialysis and of course he will miraculously come to his senses!!!) I would like to know how other places handle this and possibly similar situations. Of course I'm refering to people who have at one time consented to tx because of their ESRD. thanx

Wow! I've never heard of forced dialysis treatments on a violent psych patient! However, if you have a court order it has to be done. Maybe his family will come in to help? If not, yes it sounds like you will have to do whatever it takes in order for him to have his treatment. Good luck