HrvatskiThe Psychological and Ethical Specificities of Dialysis Treatment of the Elderly
1 Marta Klarić
2 Jagoda Nikić
3 Dragan Klarić
1 General Hospital, Zadar, Croatia
2 Nursing school Mlinarska, Zagreb, Croatia
3 Department of Nephrology and Dialysis, Zadar General Hospital, Zadar, Croatia
Summary
Nephrologists often deal with dialysis treatment of the elderly, considering that life expectancy has been increased. Somatic treatment has been shown to be quite complicated, which requires expertise, as well as empathy. Nephrologists should understand the basics of psychological functioning in this particular group of patients in order to enhance competence and decisionmaking. Defence mechanisms play an important role and may shape how patients cope with distressing aspects of illness. Treatment is ideal when a patient is cooperative. However, psychiatric advice and/or treatment may be necessary if, for any reason, the patient becomes non-adherent or refuses treatment. Moreover, physicians are often confronted with ethical dilemmas when somatic, psychological and/or psychiatric treatment methods have been exhausted. It is a physician’s duty to provide appropriate care to all patients, including
patients with dementia and those at the end of life. Most of the time, family members demand maximal treatment; however, in some cases, family members urge cessation of treatment among these patients. The aim of this paper is to provide an analytical clinical case discussion of psychological and ethical specificities in dialysis care in advanced age, rather than an empirical investigation.
Keywords: elderly patients, dialysis, ethical dilemma
Article received: 03.09.2025.
Article accepted: 31.01.2026.
https://doi.org/10.24141/1/12/2/5