Hemodialysis, Rehabilitation, and Psychological Support

Abstract

Hemodialysis for chronic kidney failure has been technically feasible since the early 1960s, when the devising of shunt access into the patient’s blood circulation created the possibility of repetitive dialysis on a long-term basis. With that, dialysis became a life-prolonging technology. In the 15 years since its inception, it has become a widely accepted and practiced technique. Seen in pragmatic cost-benefit terms, it is expensive in resources and money, yet the concomitant benefits are great. Dialysis provides not only sheer life prolongation but also a basis for the patient to live a life which is relatively normal in interpersonal relationships, productive activities, and level of satisfaction. The dialysis patient can, despite the constraints of treatment, achieve a high level of rehabilitation. However, the full potentials of rehabilitation under dialysis have not yet been widely achieved. In this chapter we will examine psychosocial constraints upon the dialysis patient which prevent optimum rehabilitation and discuss psychotherapeutic activities which promise benefit.