4 Things to Consider When Educating the Dialysis Patient

Multiple approaches and considerations for teaching the dialysis patient experiencing cognitive deficit. Specialties Urology Article


4 Things to Consider When Educating the Dialysis Patient

Importance of Education

Dialysis is a lifesaving therapy.  Patients who understand their disease process and the impacts of dialysis on their disease process and quality of life may experience positive outcomes and an increased life expectancy. Education is key.  However, the multiple barriers that dialysis patients face can make education difficult, and positive outcomes seem out of reach.  

Every care plan written for a dialysis patient requires some sort of education. There is a lot of education to be shared. Disease education, treatment options education, medication education, nutrition, and whatever personal education a patient may need. Nurses can become frustrated and have a sense of loss when they must repeat the same education to the same patient.  It would appear the patient does not care and actively chooses to be a bystander in their care.

This is the reality of educating a dialysis patient.  Understanding the etiology of the incessant need to repeat yourself and re-educate can make it less frustrating.  There is one key thing to remember when educating the dialysis patient.  Patients on dialysis have a cognitive impairment (NCBI).  Understanding this condition can allow for a personal approach to educating the dialysis patient.

Brain Fog

The decline in cognition can present as a “brain fog” ( Brain Fog on Dialysis). Brain fog creates a barrier to education leading to decreased compliance and participation in care. Patients may no longer retain information, be able to read for more than several minutes, or stay awake.

Understanding that it is common for dialysis patients to have cognitive decline, imagine being new to dialysis. Imagine not only being new but being a patient who never expected to be there.  This can create an additional barrier to education.  The stress and fear can create a confusion of its own and then there are nurses, patient care technicians, dieticians, and social workers all giving this new patient new information.  It is almost unfair to expect that the information would be understood and retained.

New patients are not alone when it comes to understanding and retention. Experienced patients experience these deficits, too. It is the nurses’ job to identify these patients and ensure that they receive all necessary education in a way that they can understand. These four simple considerations can produce such results.

Identify At-Risk Patients

By identifying the patients that are likely to experience a cognitive deficiency, you can personalize the teaching methods for these patients.  Those patients identified without deficiency will require less time for education.  The nurse will then be able to allot time appropriately for those with deficiency and require more time for education. Any minute of extra time that nurses can find is a present. 

Consider Learning Method

Consider the best way for the patient to learn.  If the patient is unable to get through a paragraph without their mind wandering, consider a video.  What about an interactive learning approach? Would a patient do better with a fill-in-the-blank or a word find?  Understanding where the patient’s cognitive decline has impacted their learning and how the patient learns, you can create material that will be best received by the patient.

Promote Retention

A form of cognitive decline is decreased memory.  Information cannot be retained.  To help with retention, create multiple materials on the same subject, increase repetition and exposure to the topic.  Consider creating materials with the subject matter presented differently in each piece. Leaving information with the patient for self-learning and presenting it multiple times in many forms, again frees up time. It gives the nurse additional time to return later and be available for any questions.

Celebrate Successes

Recognize, and even celebrate, the positive outcomes resulting from the patient’s new understanding of the topic being taught. Do not let it end there. Continue to reinforce the success.  Dialysis can be stressful and any positivity that is present in the clinic can only encourage the patient.

Taking the time to identify the patients with cognitive deficiency, considering how they learn, promoting retention, and celebrating successes the nurse may no longer be frustrated and have a sense of loss. The nurse and the patient will both see the positive outcomes.  The patient will show participation in their care.  The relationship between the nurse and patient change, impacting the whole dialysis experience for both.


Everything you want to know about brain fog on dialysis. Home Dialysis Central. (n.d.). Retrieved January 11, 2022

The effects of dialysis modality choice on cognitive functions in patients with end-stage renal failure: A protocol for systematic review and meta-analysis. 

Dawn Sheldon, MSN, RN is CEO of Sheldon Health Writing, LLC. She has 15 years experience in dialysis; 12 of that in nursing. She also has experience with home health nursing. She holds a BS in Computer Science and BA in biology. Before nursing, she worked in immunology research and DNA sequencing.

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20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Thank  you  for this informative article!

Dawn Sheldon

1 Article; 2 Posts

Specializes in Dialysis, home health.

You're very welcome.  I'm glad you found some value in the piece.


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
On 1/26/2022 at 12:32 PM, Dawn Sheldon said:

You're very welcome.  I'm glad you found some value in the piece.

I did. I appreciate it.

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