URGANT ADVICE REGARDING DIALYSIS

Hey thanks for stopping by.

I am in need of urgant advice, i support a gentleman with Austim and recently had some bad news regarding his health,

They have said he has a month to live but could get better with Dialysis. the problem is, he will not allow anyone to use a needle on him, to get bloods last time he had to be sudated under GA.

The hospital have said they can not do this for Dialysis.

Has anyone experienced this or have any idea on how we can get around the problems.

I do not want to give up on the idea we can get this done

Parents
  • OK, here's a couple of ideas that might help... Sounds like you might already know a bit about this but just in case I'll write a fairly in depth version...

    At childrens hospitals with young children what they do is to act out scenarios with a toy.  So for example in this case it might be Teddy feels ill, Teddy has a needle, lies down for a bit getting his blood washed, and Teddy feels much better.  All done with as realistic equipment as possible: there are actually toy tubes etc available, but real ones could be used if you can get hold of them.  The 'toy' in this case you might change to an object of interest.  Eg if he likes trains you could have a sick toy train!  By the way, at Gt Ormond St (where I used to volunteer and took part in some of these kinds of scenarios) very young children were involved in decision making in some cases.

    You could use a training method called shaping: this is from my experience with animals, but it does work on humans too!  Basically you break what you want down into small stages and do lots of repeats at each stage, with rewards, only very gradually working towards the full behavior.  So you might start with just showing a syringe, then rewarding him.  Repeat several times. Then touching his arm with the syringe, and rewarding.  Working up, through lots of stages, to having something taped to his arm while he stays still for a while!  Then you'd need to work on increasing the time: you'd probably need to find something to do that he's willing to stay still with?

    Might be controversial, but it might be an idea to get him used to having his arm tied down. I'm not sure if this would be allowed?  I'm thinking the rule would be if he wants the restraint removed, he gets it removed.  Him allowing it, and increasing the time allowed would be shaped. So it's never about force, but it's a reminder that he can't just suddenly pull away and get up: there has to be a little ritual before he gets up so he doesn't just pull all the tubes out!  An alternative 'ritual' for before he gets up might be better, but I'm not sure what would work!

    Many zoo animals, including great apes and big cats, are trained to offer limbs through holes in barriers for injections etc, so if they can do it...

    On the other hand dialysis is rarely done on animals: besides the expense, and problems with some species, it's generally considered just too distressing for animals that don't know what's going on.  Training to accept it might be possible, but is not a quick option as I've described above.

    Diet can help somewhat with kidney problems (and if it's acute, I've heard it can sometimes give time for recovery: I think it was David Bellamy survived acute kidney failure before dialysis was available by eating nothing but stewed apples...). But it's not going to cure chronic kidney failure and again it may be a welfare question.

Reply
  • OK, here's a couple of ideas that might help... Sounds like you might already know a bit about this but just in case I'll write a fairly in depth version...

    At childrens hospitals with young children what they do is to act out scenarios with a toy.  So for example in this case it might be Teddy feels ill, Teddy has a needle, lies down for a bit getting his blood washed, and Teddy feels much better.  All done with as realistic equipment as possible: there are actually toy tubes etc available, but real ones could be used if you can get hold of them.  The 'toy' in this case you might change to an object of interest.  Eg if he likes trains you could have a sick toy train!  By the way, at Gt Ormond St (where I used to volunteer and took part in some of these kinds of scenarios) very young children were involved in decision making in some cases.

    You could use a training method called shaping: this is from my experience with animals, but it does work on humans too!  Basically you break what you want down into small stages and do lots of repeats at each stage, with rewards, only very gradually working towards the full behavior.  So you might start with just showing a syringe, then rewarding him.  Repeat several times. Then touching his arm with the syringe, and rewarding.  Working up, through lots of stages, to having something taped to his arm while he stays still for a while!  Then you'd need to work on increasing the time: you'd probably need to find something to do that he's willing to stay still with?

    Might be controversial, but it might be an idea to get him used to having his arm tied down. I'm not sure if this would be allowed?  I'm thinking the rule would be if he wants the restraint removed, he gets it removed.  Him allowing it, and increasing the time allowed would be shaped. So it's never about force, but it's a reminder that he can't just suddenly pull away and get up: there has to be a little ritual before he gets up so he doesn't just pull all the tubes out!  An alternative 'ritual' for before he gets up might be better, but I'm not sure what would work!

    Many zoo animals, including great apes and big cats, are trained to offer limbs through holes in barriers for injections etc, so if they can do it...

    On the other hand dialysis is rarely done on animals: besides the expense, and problems with some species, it's generally considered just too distressing for animals that don't know what's going on.  Training to accept it might be possible, but is not a quick option as I've described above.

    Diet can help somewhat with kidney problems (and if it's acute, I've heard it can sometimes give time for recovery: I think it was David Bellamy survived acute kidney failure before dialysis was available by eating nothing but stewed apples...). But it's not going to cure chronic kidney failure and again it may be a welfare question.

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