The high death rate among dialysis patients with supportive families might have another cause
While researching dialysis-related topics on the internet, I found a description of a study that found that dialysis patients who had supportive families had a higher death rate than those patients whose families were unsupportive. The Family Systems theorist supposed that the higher death rate was caused by the dialysis patients 'giving up' so as not to prolong their burden on their families.
I am a dialysis patient, and I think there's another reason why the death rate might be so high for the patients with supportive families: The families do too much for the patient, who is considered 'too sick' to do many of the everyday tasks he or she previously did. While the patient may indeed be too ill to do very much when he or she starts dialysis, after a few months of treatment, normal activities can slowly be resumed-- physical deconditioning happens rapidly on dialysis because the 4-hour treatments encourage a sedentary lifestyle.
I wouldn't encourage anyone to make Grandma carry a 30-pound basket of laundry down to the cellar, but she can certainly help put groceries away, water the flowers, wash dishes and help cook dinner. Keeping dialysis patients involved in daily life will prevent them from feeling like a 'burden' on their families and encourage them to retain or regain their strength. I know from experience that once you are called 'disabled,' you start to think of yourself as being handicapped in every area of your life... and it's very tempting to blame every mistake or failure on your being a dialysis patient.
"Tough love" isn't just for unruly teenagers... for dialysis patients who have become helpless because of family 'concern,' it might be a lifesaver.