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“I Realized It Was Kind of Too Late” Integrating Advance Care Planning into the Care of Patients with Kidney Disease

  • 1 Dale Lupu, MPH, is affiliated with the Center for Aging, Health and Humanities, George Washington University, Washington DC
  • | 2 Alvin H. Moss, MD, is affiliated with West Virginia University School of Medicine Sections of Nephrology and Supportive Care, Morgantown, WV
  • | 3 Nancy Armistead, MPA, and Brandy Vinson are affiliated with Quality Insights Mid-Atlantic Renal Coalition, Richmond, VA.
  • | 4 Nancy Armistead, MPA, and Brandy Vinson are affiliated with Quality Insights Mid-Atlantic Renal Coalition, Richmond, VA.
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“There’s no doubt that my wife and I waited too long to have that discussion, and part of that is—my wife is very quiet … we’ve been married for 55 years. So we never really had that discussion. And before I realized, it was kind of too late.” (interview 6, man, health care proxy for patient with cognitive impairment)(1).

“I think that discussion should come before you get to the critical point. At the jump of a dime things could turn, so I think the more prepared you are, the better you could handle things when situations get

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