Providing supportive care to patients with kidney disease.

While it may never be "easy" to face these issues with patients, families, and caregivers, CSCKP hopes the best practices and tools outlined in this article, also available at www.kidney-supportivecare.org, will be helpful to renal professionals in providing quality supportive and end-of-life care to their patients. Encouraging and participating in shared decision making with patients and their loved ones can help all involved create an approach to care with which everyone is comfortable. The relationships formed through shared decision making will help keep the lines of communication open, which is essential as needs and prognosis change. This type of health care provider/patient relationship may also encourage patients to share more about their symptoms, as not all patients are forthcoming about their symptoms or pain, and thereby facilitate better assessment and treatment by clinicians. Working with a palliative care specialist may be necessary when symptoms become more challenging to manage and referral to hospice may need to be considered. Helping patients, families, and caregivers understand their options, assisting them in completing advance care plans, and ultimately respecting their wishes are all encompassed within the delivery of patient-centered care.