Development of a pamphlet: introducing advance directives to hemodialysis patients and their families.

The proportion of patients starting renal replacement therapy who are elderly, dependent and have multiple co-morbidities is the fastest growing chronic kidney disease (CKD) population in Canada. Most professional nephrology organizations recommend that hemodialysis patients should be encouraged to write advance directives (AD). Advance directives or advance care planning (ACP) are terms that refer to instructions given by an individual that state his or her wishes for future medical treatment and personal care.