Deciding to stop dialysis is a deeply personal and complex choice that affects both you and your loved ones. Dialysis, while life-sustaining, can also be physically and emotionally taxing, and some may feel that its impact on their quality of life no longer outweighs its benefits. Before making this decision, it’s important to discuss it with your healthcare team and family members to understand the full implications, medically and emotionally.*

Exploring Your Right to Choose

Stopping dialysis is a legal choice for patients who feel that continuing treatment no longer serves their well-being. Patients are encouraged to communicate their reasons—such as diminished health or psychological distress—to their healthcare providers. 

This discussion allows the team to assess if adjustments to the treatment plan might enhance quality of life, making the decision to stop more informed. Many healthcare teams are understanding and supportive, aiming to respect patient autonomy while offering guidance.

A healthcare team may also recommend consulting a mental health professional, particularly if emotional challenges like depression influence the decision. This support can ensure patients understand the full impact of stopping dialysis and provide coping strategies. 

For some, addressing emotional or mental health issues may even renew the desire to continue treatment, while for others it solidifies their choice to stop.

Preparing for End-of-Life Care

When stopping dialysis, planning for end-of-life care is crucial to ensure comfort and dignity. Patients often have the option of hospice care, which provides palliative services in various settings, including:

• Home,  
• Hospitals, and 
• Hospice facilities. 

A social worker can assist with these arrangements, ensuring that patients receive sufficient support and that loved ones have access to resources, such as home health aides, if required. 

Hospice care generally covers medical and emotional support tailored to the patient’s preferences, including pain management and assistance with breathing difficulties.

For those choosing to die at home, social workers can help coordinate additional support services. Some insurance plans cover home health aides, while other families may need to arrange and pay for these services privately. 

Choosing a location for end-of-life care is a personal decision, and healthcare teams will aim to accommodate these preferences as much as possible.

Considering Practical and Legal Matters

Before stopping dialysis, it’s wise to address practical and legal arrangements. Patients should consider completing legal documents, such as a healthcare proxy and/or durable power of attorney, to designate a trusted individual to make healthcare decisions if they become unable to do so themselves. This ensures that their wishes regarding medical treatment are followed. 

Additionally, other personal and financial documents should be organized to reduce burdens on loved ones. These include:

• Wills,  
• Property inventories, and 
• Funeral preferences.

Medicare typically continues to cover costs even if dialysis is discontinued, but verifying insurance coverage for other end-of-life care expenses is recommended. Should a patient change their mind after stopping dialysis, they generally can resume treatment, although initial discomfort may arise.

*National Kidney Foundation. (n.d.). Dialysis – Deciding to Stop. Retrieved from https://www.kidney.org/kidney-topics/dialysis-deciding-to-stop#:~