Improving The Well-Being of Dialysis Patients, an OT Approach

It is possible that you may know someone that was diagnosed with Chronic Kidney Disease (CKD). It is also very likely that you or someone you know is suffering from Diabetes, High Blood pressure, or both. These two chronic conditions are among the leading causes of kidney disease.  Another cause is frequent urinary tract infections. According to the U.S Department of Health and Human Services, 1 in 10 American adults (more than 20 million people) have some form of Chronic Kidney Disease.  End Stage Renal Disease, (ESRD) is when there is total damage to the kidney and the patient needs to undergo dialysis treatment. According to the U.S Department of Health and Human Services, the prevalence of ESRD between 1980 and 2009 has increased by almost 600 percent from 290 to 1,738 clients for every million cases.

George Washington University conducted a study examining the quality of life and psychosocial issues affecting dialysis patients. They found that depression is the most prevalent psychological symptom affecting dialysis patients. Researchers believe that dialysis patients may feel depressed due to their heightened awareness of the possibility of death.  Other reasons were linked to the feeling of loss of independence, increased family burden, and decreased physical level of function.

Occupational therapy can help individuals undergoing dialysis treatment live a more fulfilling and healthy life by helping them modify or adapt the activities they perform. Occupational therapists have been uniquely trained to break down tasks into individual components to better understand the performance demands it has on the individual. The occupational therapist uses a client- centered approach to find out what are the most important daily activities to the client. Then they establish a parallel between the demands of each specific task and how much effort is required by the patient to perform it.  Once this parallel has been drawn, the occupational therapist formulates a work plan which may include ways to improve the patient’s ability to maintain an adequate level of function that would allow the patient to continue performing the task. If the patient is no longer able to perform the task the way he or she is accustomed to do so, the occupational therapist will develop a list of alternate ways to perform the task successfully.

For instance, I had a patient not too long ago that has been receiving dialysis for over 10 years.  In the recent years, she has been experiencing increased pain in her legs due to peripheral neuropathy which makes it difficult for her to enjoy one of her favorite past-times- window shopping. I understood that 10 years of dialysis and the effects of Diabetes had taken a toll on this patient’s body, but not on her mind.  Although she was not feeling optimistic about her future prognosis because of her medical condition, she still wanted to feel alive and do the things she enjoyed. So I worked with her and her case manager to develop a plan that included: an exercise regimen; proper footwear selection; implementation of energy conservation techniques; training on fall and safety precautions; appropriate and convenient means of transportation; amongst other things. We were also able to modify the way the patient performed the activity of window shopping, so that she could continue to do so successfully. Through the implementation of strategies and adapting the task, she is currently able to window shop and is happy to do so.


Miller Calberto, MS, OTR/L , CAPS

Senior Partner

Adapting Spaces, LLC


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