Mom has dementia, uses walker, incontinent and has stage 4 kidney disease. Dr. says we need to decide on dialysis.

If you elect to decline Dialysis ask the doctor if she would be considered Hospice eligible. If so call and "interview" Hospices in your area and have your mom evaluated.
2 things to know.
1. She would probably be considered Hospice eligible due to the dementia.
2. She wold be considered Hospice eligible due to declining dialysis treatment.
If she goes on Hospice because of the dementia you can later decide to try dialysis and she could remain on Hospice. On the other hand if she enters Hospice because she is declining dialysis if you later decide to try it she would not be eligible for Hospice (they could change the diagnosis to dementia though)
Personally if her quality of life is not good if it were me I would elect to NOT do dialysis and go on Hospice and let them help me manage any pain or discomfort I may have.
There are many advantages to having Hospice.
She/you will have a Nurse that will come at least 1 time a week to check on her. A CNA at least 2 times a week to help bathe and dress her as well as order supplies.
You will have medications delivered to you as well as other supplies.
If equipment is needed that will be delivered to you as well.
Honestly I can not see a downside to going on Hospice.
There are 2 types. One is a For Profit the other is Not for Profit. The Hospice I used for my Husband was a Not for Profit and I could not have been more pleased. The goal was patient focused not saving or making money.

Absolutely not! Google Atul Gawande and " being mortal" for a doctor's take on end of life care. You would not be extending her life for any kind of positive comprehension. That would be cruel to put her through a process she cannot understand. Sign her on to hospice and allow her to pass in peace.

Did your mom ever make any advanced directives? Or did she ever indicate to the family what type of interventions she would or would not want in her declining health? That is where I would start. Next I would consider a family meeting or conference call. These are difficult decisions but they’re even more difficult if there’s dissenting opinions amongst family members.

About a year ago, I was faced with a similar situation. My father required surgical intervention for a heart condition. We decided against it and contacted our local hospices as Grandma1954 suggested. It’s been a good decision for us. It’s given him quality of life and I don’t believe the surgery would have given him quality or quantity. As you said, I don’t think he could’ve handled it.

No matter what you decide, I wish you peace and comfort. I understand how tough this is.

I'd consider what she would want and look at any Advance Medical directive if she has one. I did a lot of reading when my LO got sick with dementia. I was surprised at all of the professional literature about not proceeding with life extending measures, when someone is terminally ill, which dementia is considered. So, we went with palliative care, then hospice when she qualified. The goal is comfort care and not to extend life, due to her failing health and extremely low quality of life. You can discuss it with her doctor and/or hospice to see what each path would look like.

I would contact hospice. I think sometimes the body naturally takes the best course for our loved ones with dementia. It's a progressive downward trajectory. Wishing you peace.

My mom’s kidneys were failing her, she was in and out of the hospital and had stated before she wasn’t going to do dialysis. When we took her into the appointment with the doctor after he had explained what would be done and how often, I only had one question for him. “ Would he put his mom on dialysis if she had all the health issues that my mother had?” His answer was No.
What you and your family have to decide is it going to improve her other health issues? Dialysis is very hard on a person and you are looking at several times a week, each time takes hours. The chances of her pulling the needles out are high if she has dementia. I know we all want our loved ones to live forever, but a some point we need to protect them from medicinal treatments that will do more harm than good.

This is what you need to ask the doctor. Will her body be able to take it. Isn't it like 3x a week and 6 hrs of sitting? Can she do this? Home dialysis involves a lot and training.

The option is to do nothing and putting Mom on Hospice. Eventually the Toxins will make her septic and she will pass. So sorry that u need to make this decision.

One of my college roommates is a nephrologist. Her motto is "I don't dialyze bodies". Dialysis is intense. Most people do not realize how intense. It's fatiguing. Some patients go into cardiac arrest during dialysis. Dialysis is a commitment to three times per week for hours at a time. In my opinion, it's time to get consults for both hospice and palliative care on board for your mom.

You don’t mentioned if she has an advanced directive. I would not think dialysis at this point in her health is a viable option. For what end? To prolong her life so she can continue to sit in her bodily fluids and to exist. Has anyone explained how hard it is to go through dialysis? If it were my parent in the mental and physical condition you state, I would say No. let the body die a natural death and get hospice on board. End stage rental failure is one of the criteria for acceptance. The dementia diagnosis is much more strict under their guidelines. They must have ceased communicating.

Don’t put her through dialysis. It sucks the life iut of patients. She is already weak.