000 02548cam a2200373 4500500
005 20250121121221.0
041 _afre
042 _adc
100 1 0 _aGuerin-Lacroute,
_eauthor
245 0 0 _aPre-therapeutic geriatric assessment in pre-dialysis
260 _c2023.
500 _a4
520 _aOlder adults with chronic renal insufficiency may need a geriatric pre-therapeutic assessment when the disease becomes severe. At this stage a discussion is needed on the most appropriate treatment: to initiate dialysis or pursue maximum medical management. A comprehensive geriatric evaluation (medical-psycho-social) follows a standardized procedure, which aims to reveal and quantify the limits and frailty of the older patient. However, beyond determining risk and survival thresholds, the consultation is an opportunity to record the patient’s story at a critical point in the evolution of the disease. A narrative identity emerges from the standardized questionnaire. As a result, the evaluating geriatrician can navigate the care pathway by interpreting quantitative data alongside the patient’s account. This interplay between heterogeneous data, resulting from an ongoing dialectic between analysis and perception, numbers and words, raw data and interpretation, eventually reveals which of the treatment options is most pertinent. To take into account the singularity of each patient’s situation, it is necessary to rank the collected data. The evaluation report thus takes the form of an argument-based essay rather than a succession of raw data points. This approach allows the patient and nephrologist to construct the care pathway in the light of new meaningful elements.
690 _apatient’s story
690 _aargument-based essay
690 _aconcern
690 _aolder patients
690 _anarrative identity
690 _asense making
690 _adialysis
690 _apre-therapeutic geriatric assessment
690 _asevere chronic renal failure
690 _apatient story
690 _aconcern
690 _aElderly patients
690 _anarrative identity
690 _asense making
690 _aargumentative essay
690 _apre-­therapeutic geriatric assessment
690 _adialysis
690 _asevere chronic renal failure
786 0 _nRevue française d'éthique appliquée | o 13 | 2 | 2023-04-07 | p. 154-169 | 2494-5757
856 4 1 _uhttps://shs.cairn.info/journal-revue-francaise-d-ethique-appliquee-2022-2-page-154?lang=en&redirect-ssocas=7080
999 _c553709
_d553709