Living with chronic kidney failure means changes in many aspects of your life. The social worker is trained to help you and your family cope with changes in your emotional, family, and day-to-day life. The social worker consults with doctors, nurses, and dietitians.

How you handle the changes and your feelings about kidney disease and dialysis are important factors in your treatment. Seeing a social worker is an important step in taking care of yourself.

Social Services

Social workers have the education and experience to help patients and their families adjust to chronic illness and its treatment. They are qualified to provide counseling, emotional support and methods for problem solving to those who ask for such help.

Topics that patients often ask for help with include:

• Adjustment to dialysis
• Personal problems
• Insurance, Medicare, and financial aid applications
• Financial concerns
• Employment or vocational rehabilitation
• Transportation to and from dialysis
• Travel arrangements
• Insurance claims and medical bills
• Home care needs

Discussions between the social worker and the patient or family are private communications. Counseling can be given on an individual, family, or group basis. Some of the issues often discussed in counseling are depression, anxiety, marital and family stress, concerns about death and dying, and sexual problems.

As a member of your health care team, the social worker may share information with other members of the team in written records and conferences. This enables the rest of the team to be aware of the unique qualities of each patient and family, and enhances the care provided to you. Only information which is felt to be necessary to your care will be shared, and the social worker is careful to maintain confidentiality according to the standards of the social work profession.

Your social worker can also help you solve specific problems involving money, work, transportation, insurance, etc. Sometimes she or he will refer you to resources such as community agencies and help you in making use of those resources.

Work

You are encouraged to return to work or continue with your education full-time or part-time. You may need to change your job to one that is less stressful or physically demanding than your current one. Every effort will be made to arrange your dialysis treatments around your work schedule or school schedule.

If you don’t return to work or school, it’s important to use your time in a way that makes you feel productive. Look into volunteer, leisure, or educational programs that interest you. Your social worker can help you find out about job retraining and other work and educational opportunities.

If you aren’t able to go back to work, your social worker can give you eligibility information about Social Security Disability and Supplemental Security Income benefits. Both of these federal programs can provide qualified people with a monthly income.

Sexuality

Many dialysis patients experience a decrease in their desire for sexual activity due to changes in physical and emotional health. Impotence, the inability of the male to have or maintain an erection, may occur.

There is no known single cause for these changes, but there are several physical and psychological factors that are thought to contribute to them. Stress and anxiety due to kidney disease and treatment may affect your sexual desire and ability to enjoy sex. Other factors that may influence your interest in sex include medications, diet, anemia, lack of sleep, inadequate dialysis, and changes in hormone balance.

If you have sexual problems or concerns, your social worker is available to discuss them. Counseling may be helpful for both partners. Because some sexual problems may stem from physical problems that are treatable, you may want to talk to your doctor as well.

Dining Out

You can eat out even though you are on a renal diet. Following your diet plan, you can choose foods from almost any menu. Most restaurants are willing to cater to special requests, even fast food chains. You can get menus from your favorite restaurants and talk about choices ahead of time with your dietician.

If you are celebrating a special occasion, you might want to eat a little less than usual at breakfast and lunch so you can have a little extra for dinner. But be sure to check with your dietitian before changing your food pattern.

Excerise

A regular exercise program has many benefits for dialysis patients. Physically, exercise can fight symptoms of anemia (low blood cell count) and as a result improve your energy level. It may also improve your blood pressure, muscle and bone strength, weight control, and sleep. Psychologically, exercising can lower anxiety, improve self-esteem, and give you a sense of control over your body.

Some exercises kidney patients enjoy are walking, jogging, swimming, and biking. Ask your doctor what type of exercise would be best for you, as well as how often, for how long and how intensely you should do it. If you are a hemodialysis patient, some exercises can be done while you are on the hemodialysis machine. Ask your health care team what is available at your unit.

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