More than half of the people who receive dialysis start their treatment in an emergent, unplanned way often called “crashing.” The sudden discovery that a regular, life-sustaining treatment must begin immediately can leave a patient emotionally shaken and in need of answers.
Often patients will turn to a social worker as a helpful ally and source of reassurance.
A DaVita teammate (employee) with more than 30 years of experience as a social worker, Elizabeth Jones finds her role creates a unique bond between her and the people she cares for.
This starts with understanding what they know about their treatment options to help better prepare them for informed conversations with their physicians.
“I ask [them] during their initial assessment if they’ve heard of transplant,” Jones says. “It’s all about being able to encourage patients and letting them know of the different opportunities that are out there for them.”
The role of a DaVita social worker includes providing transplant education, within the patient’s first 30 days of starting dialysis. Jones explains that individual patients may need to overcome several barriers in order to be placed on the transplant list, such as meeting financial requirements or having a caregiver in place. Jones identifies overcoming these and other barriers as a key reason to educate patients from the onset of treatment—that way discussions around resources and support can begin.
By proactively providing information and identifying the challenges and potential solutions available, social workers can help empower patients as they work with their nephrologists and care team to manage their kidney health and consider transplantation.
“I like to break it down into smaller pieces,” Jones says. “I work with them to create goals, and keep them mindful of the transplant process and the different steps that are required.”
Jones was initially assigned to be a cardiology social worker, but was diagnosed with idiopathic proteinuria in 1991 after a preemployment physical found blood and protein in her urine. This resulted in a delay in employment and a change: Instead of cardiology, Jones ended up starting in renal and endocrine social work. In 1995, she underwent a biopsy and was then diagnosed with primary membranous glomerulopathy.
Her own personal kidney disease journey has helped pave the way for her career and passion as a DaVita social worker. She’s shared her own personal story with her federal state senators, congressman and before a congressional committee to advocate for improvements in kidney care.
“It was kind of fate that I became a renal social worker instead of cardiology,” Jones says. “I thought if I was going to be the one counseling patients and educating them, I’m going to have to adjust to this too.”
While patients typically work with their nephrologists and a separate transplant team, social workers also prove to be a valuable resource as the kidney transplant process is fairly long and complicated.
Individuals often look to social workers to help keep them on track. Jones informs patients of the importance of staying on top of medications, diet and nutrition, and doctors’ appointments. She says they’re most surprised to learn that transplantation is a method of treatment and not a cure, and that they’re still required to take medications during the life of the kidney.
“The more control a patient has in their lives and their medical care, the more they’ll be able to adapt and thrive with dialysis—and through their transplant journey,” Jones says.
For Jones, educating patients that transplantation may give them the longest chance at life with kidney disease is critical. She encourages them and helps them realize they can make it on the transplant list, even if they don’t think they can.
“I’ve had patients say to me, ‘You’ve been with me the whole time,’” she says. “To me, it’s meaningful that I’ve been a constant in their life through their kidney disease journey.”
 Transplantation is associated with lower mortality rates for adults with ESRD. Source: 2021 USRDS Annual Data Report, Figure 6.1 All-cause mortality in adult ESRD patients, by treatment modality, 2009–2019; https://adr.usrds.org/2021/end-stage-renal-disease/6-mortality