Positive Approaches to Living with End Stage Renal Disease: Psychosocial and Thanatologic Aspects

Positive Approaches to Living with End Stage Renal Disease: Psychosocial and Thanatologic Aspects

Positive Approaches to Living with End Stage Renal Disease: Psychosocial and Thanatologic Aspects

Positive Approaches to Living with End Stage Renal Disease: Psychosocial and Thanatologic Aspects

Synopsis

Aspects of cancer and cancer therapies; long-term adjustments of renal donors and recipients; community life (including support facilities and home dialysis); medical aspects of End Stage Renal Disease (ESRD); psychiatric disturbances; public policy issues; the role of the doctor, staff, and society, sexuality and loss of sexual function, surgical aspects; and anticipatory grief, acute grief, and bereavement are all discussed in this book for caregivers working with ESRD patients.

Excerpt

Sally K. Severino,Mark Fulcomer, Stephen W. Hurt, and George L. Hogben

From in-depth interviewing of one renal hemodialysis patient (185 sessions over a two-year period) who seemed well adjusted to renal hemodialysis, it was noted that she consciously verbalized both her anthropomorphization of the machine and her feelings that she felt like a machine (Severino 1980). in other words, she clearly described how she treated the dialysis machine as though it were a person and how she felt herself to be a machine. the question arose, "Was this true of other dialysis patients?"

A search of the literature revealed no attempts to test this hypothesis in an objective way. Abram (1969) and Kemph (1966) have reported their observations of individual cases where patients seemed to take the dialysis machine into their body images and think of themselves as not totally human. Abram also alluded to the patients' making friends with the machines -- that is, treating the machines as humans (Abram 1970). De-Nour (1969) noted that loss of the ability to urinate could enhance a feeling of being "half-human." That the loss of a kidney would alter a patient's self-image in significant ways, including feelings of vitality, strength, and virility, was stressed by LeFebvre, Crombez, and Lebeuf (1973). Implicit in a paper by Shea et al. (1965) is the concept that age may affect the patient's reaction to the dialysis machine. Shea's paper stressed an adolescent patient's struggle to maintain his sense of identity when confronted with the machine's constant threat at a stage of life where one's sense of identity usually is consolidated.

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