Bioethical considerations on the status of caregivers assisting dialysis patients

Abstract

For assistance of dialysis patients, the long-term burden on caregivers, especially the volunteers and unpaid ones, may lead to the development of a burnout syndrome. Taking into account the increasing number of end-stage renal disease (ESRD) patients needing dialysis treatment, which is globally causing problems for the healthcare system, it is worth discussing in bioethical terms the whole problem of caregivers of dialysis patients. In an observational, multicenter survey including 201 unpaid caregivers of hemodialysis patients, burnout syndrome was recorded in 24% of them, and excessive psychosocial and physical burden of care in 41%, while only 6% of them reported a condition of serenity. A worse burden on caregivers was found when they assisted patients on daily or nocturnal hemodialysis; the extent of perceived caregiver burden was unrelated to demographic factors, but was significantly associated with poorer self-reported quality of life and depression. Such data suggest the need to accurately establish the net benefit/detriment of these intensive dialysis strategies, thus considering also the field of bioethics in Nephrology. (Bioethics)