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Emotional and Family Support

The care and challenges related to your illness and having a dialysis access surgery raises its own set of emotional and coping issues - for you, your loved ones, caregiver(s) and friends.

Our behavioral health team, which includes a psychologist, social workers and a psychiatrist, if needed, has created a special program to address a unique circle of need.

We help you understand the physical, emotional and financial impact of your disease and the impact on your family, including children. Together we develop strategies to handle the many special challenges associated with your illness, access surgery and care.

Positive Outlook, Positive Outcome

Our behavioral health program helps enhance care quality and patient outcomes by supporting patients and their families, before, during and after dialysis access surgery. Studies show that emotional health and well-being play an important role in recovery and improved physical health. We know that factors such as depression and anxiety can impact quality of life. Patients with untreated depression are at higher risk of relapsing to substance abuse, not taking their medications, and not attending to their physical health needs.

Managing Stress

Stress is part of life. But too much stress - for too long - is not good for your emotional or physical health. One of the keys to living a long and healthy life is to find your own personal ways for dealing with stress. The following are some ideas for lowering your stress level:

  • Maintain a healthy lifestyle - eat healthy foods, exercise and get enough sleep and rest. Write down the activities that relax you, such as taking a bath, going for a walk, or listening to a relaxation tape. When you feel stressed, take a break and do one of these things.
  • Build a support system of family and friends who will be there for you in good times and bad. When you feel overwhelmed, talk to someone about it.
  • Identify the situations that generate stress for you. Do what you can to gain more control over these situations.
  • Accept that there are some things you cannot change, and don't waste time and energy worrying about them.
  • Accept that there often are not enough hours in the day to accomplish everything you want to do.
  • Realize that everything does not have to be done perfectly.
  • Reassure yourself that you are doing the very best that you can.
  • If you feel stressed on a regular basis, or if stress is difficult to deal with, you may benefit from talking to a mental health professional. Ask your transplant team or primary care physician for a referral.

Caregiver Stress

Caregivers are a very important part of the success of dialysis.

  • Help to monitor your health
  • Help you meet basic living needs, like cooking, bathing, and simply getting around the house
  • Drive you to and from clinic appointments
  • Help keep track of your medications and when to take them
  • Communicate with the transplant healthcare team
  • Assist with taking care of your children
  • Help make healthcare decisions for you

For these reasons, it's important for the caregiver to meet the transplant team and to be an active part of the whole transplant experience. Caregivers also should learn as much as they can about the transplant process.

We recognize that caregiving can be very time consuming and stressful. Caregivers experience their own unique form of stress as they balance the demands of their loved one's illness and other life responsibilities. Many of the strategies described above can be just as useful for caregivers to prevent and better manage stress in their lives. We encourage caregivers to talk more with their social worker and/or psychologist about any concerns or worries. We can work with you to help you find the resources you need. For example, many caregivers benefit from joining caregiver support groups and participating in their own mental health treatment.

Web Sites to Support Caregivers

National Center on Caregiving
http://www.caregiver.org
The NCC helps develop high-quality and cost-effective programs and policies for caregivers in every state, and serves to unite public policy, research and services.

The Well Spouse Foundation
http://www.wellspouse.org/
Well Spouse helps support husbands, wives and partners of the chronically ill and/or disabled. There are Well Spouse support groups in many areas of the country, including Massachusetts, offering wide-ranging caregiver information on a variety of practical issues. In support groups and on the web, members share thoughts and feelings in a non-judgmental environment with those facing similar circumstances.

The Caregivers Marketplace
http://www.caregiversmarketplace.com
This web site provides rebates, discounts and information for caregivers.

Caregiver Media Group
http://www.caregiver.com
The Caregiver Media Group provides support, information and guidance for family and professional caregivers. Caregivers can access topic-specific newsletters, back issue articles from Today's Caregiver magazine, online discussion lists, chat rooms and an online store.

Empowering Caregivers
http://www.care-givers.com/
This web site provides useful resources for caregivers, has a chat room and message board, and has a newsletter.

National Family Caregivers Association
http://www.nfcacares.org
A grassroots organization, NFCA supports, educates and empowers those who care for chronically ill, disabled or aged loved ones. NFCA addresses the common concerns and needs of all family caregivers, regardless of diagnoses, relationships or life stages.

Relationship Stress

Your illness may impact your family and your friends in different ways than it impacts you. Your partner or family members probably have concerns about your health, your relationships, your children and your finances. They may do things to "help" that are not helpful at all because they do not know what to do. Try to communicate openly with your partner or the family members who are most involved in your care. Tell them when you need their help, when you are afraid, when you need them close to you, and when you need some time to yourself. Knowing your own needs and helping others to understand them will make things better for all. Your social worker and psychologist can help your family through issues that may arise and help you talk with each other about your concerns. They have experience working with couples and families under stress.

Talking to your Children

If you have children you probably are very concerned about how your illness is affecting them. They are concerned about you, too. Here is some advice about what to say to your children:

  • Keep children informed about what is happening. Children understand things and communicate differently at various developmental stages. Your social worker and psychologist can share insight and suggestions.
  • Keep things as routine as possible. If you can, let them continue after-school activities such as sports and time with friends. Reach out to other friends and family who may be able to assist you.
  • When things cannot be "routine," let your children know the plan in advance. For instance, tell them who will take care of them while you are in the hospital.
  • Spend time with your children. Doing things together like watching television, reading, or simply talking will help them understand that you are still their parent who loves them and is there for them.
  • Include the children in the transplant process. Leaving them out may make them feel unwanted and not needed.
  • Be careful not to ask too much of teenagers. They certainly can pick up more of the household responsibilities, but not at the expense of spending time with their friends and participating in the activities they enjoy.
  • Recognize that some "bad" behaviors may be the result of a child's fears about their parent's illness.

Your social worker and psychologist are available to meet with you and your family to discuss transplant concerns. They also can suggest books that have helped other families coping with illness.

Taking your Medications

We can offer special strategies to help you remember to take your medicine; to plan so that you do not run out; and to pack so that you have the medications you need if you are traveling. For instance, we will work with you and your family to create reminder cues at home so you remember to take your medicines at the same time each day. Many patients use pillboxes, calendars, notebooks, alarm clocks, and signs to help remember to take their medications. The transplant social worker, psychologist, pharmacist, or nurse can help you decide which system(s) works best for you.

Quality of Life

As part of our behavioral health program, we ask every patient to tell us about their quality of life, something that our blood tests and medical tests can't show us. We ask patients to complete a detailed survey. This information helps us continually refine our care to be sure people have the best possible experience at BIDMC.

When you have a chronic medical condition, there is a tendency to define your quality of life in terms of what you can or cannot do physically. If you define your quality of life only in physical terms, you may feel that there is nothing you can do to improve your quality of life. But there is more to quality of life than physical well being. Relationships with others, spirituality, leisure-time activities, and work, among other things, contribute to your overall contentment and happiness. While waiting for your access surgery or recovering from surgery, our expert team will help to improve your overall quality of life.

Substance Abuse

Alcohol and drug abuse can impact your physical health and compromise your dialysis. To help patients with a substance abuse history, we have developed specific treatment programs here BIDMC. These treatment programs are designed to help prevent relapse to substance abuse once you have quit drinking or using drugs. If you are unable to take advantage of the treatment programs here, we will help you find appropriate providers in your local community.

Smoking Cessation

It is also important for you to stop smoking. Nicotine is highly addictive and smoking can cause many health problems. Therefore, we encourage our patients to quit smoking.

To help patients quit smoking, we offer a short-term treatment program that can be done on an individual basis or in a small group. We use treatment strategies that have been proven to be the most effective way to quit smoking - and to stay quit.

Additional Treatment Programs

We offer a number of other treatment programs. Ask your transplant physician, nurse, social worker or psychologist if you would like more information on the following:

  • Depression
  • Pain management
  • Weight loss management
  • Insomnia
  • Sexual dysfunction
  • Enhancing support system stability

Spiritual Needs and Support

Beth Israel Deaconess Medical Center has a Pastoral Care staff onsite, including a Rabbi, Catholic priest and Protestant chaplain. There is also a network of spiritual advisors representing other faiths in the community who are available to you for consultation. Additionally, your own religious or spiritual community can be another source of comfort and support.

Contact Information

Transplant Institute
Beth Israel Deaconess Medical Center
Lowry Medical Office Building, 7th Floor
110 Francis Street
Boston, MA 02215
617-632-9700