Renal Support Services

What is a Psychologist?

Psychologists use their understanding of psychology to help people understand themselves and the difficulties they are experiencing. Some psychologists work in health settings such as hospitals, helping people to manage the emotional aspects of physical illness.

The psychologist within the Renal Service is registered with the Health and Care Professions Council (HCPC) as a qualified Counselling Psychologist and is a member of the British Psychological Society (BPS). This means that high standards of professional guidance are followed.

Unlike medical doctors, psychologists do not prescribe medication or use other physical treatments, instead they can draw on a range of therapeutic approaches including problem solving techniques, counselling and more formal psychological therapy to contribute to your overall health and emotional wellbeing.

What might a Psychologist be able to offer me?

We recognise that kidney disease can have a major impact on people’s lives and it can be hard to deal with at times. You may experience different stresses and challenges at different stages of your kidney care and these may include:
• Coming to terms with a diagnosis and adjusting to the lifestyle changes that may be required.
• Adjusting to the treatment regimen and undergoing medical procedures which make you feel worried or upset.
• Feeling depressed, anxious or angry about what is happening to you.
• The impact of other problems, not directly related to your kidney disease on your coping ability (e.g. other stress factors, long term anxiety or mood problems).
• Difficulties coping with uncertainty about your health and treatment.
• Fears about the future.

Whilst some of these problems can be dealt with by people themselves or with the help of family, friends or the health care team, others can feel more overwhelming. It can be helpful to work through these issues with someone experienced in dealing with psychological and emotional difficulties.

What will happen if I am referred?

A referral to the psychologist should be discussed with you beforehand and you should agree with the referral before it is made. The first meeting is for an assessment. This usually lasts up to one hour but it may be necessary to have more than one appointment to get a full understanding of your situation. You can meet with the psychologist on your own or you might want a particular person to come with you (e.g. partner, family member or friend).

You will be asked about your health problems and the ways in which they impact on your emotional well-being and quality of life. You will also be asked to complete a short questionnaire which you will be supported in doing. What happens next is a joint decision between you and the psychologist. If you are coping well, the decision may be not to make any further appointments at that time. If it seems that you do need further psychological help, you will be offered the opportunity to meet for a series of sessions to work on your difficulties.

Therapy is a collaborative process and may vary from one or two sessions up to ten sessions or more. You may be seen as an outpatient, while you are at the hospital for dialysis or on a hospital ward if you are an inpatient.

Will my information be confidential?

The psychologist will take notes during or after sessions which are kept separate from your medical records and stored securely and confidentially within the department. It is standard practice for the psychologist to write back to the referring professional, with a summary of the assessment and a description of the action plan. A copy of this report is usually sent to your General Practitioner and where appropriate to other medical professionals within the hospital who are interested in your care. You will also receive a copy.

In subsequent sessions the psychologist may want to share some of the things that are discussed with other team members of the renal team as it can help them to
understand more about you. However, if there is anything that you want to remain confidential, this will be respected wherever possible, subject to the need to
consider the safety of yourself and others.

Further Information

For more information about seeing a Psychologist or to discuss your referral, please contact Dr. Rebecca Verling,
Counselling Psychologist on the number
below:
Renal Psychology Service
Renal Services
Royal Shrewsbury Hospital
Mytton Oak Road
Shrewsbury
SY3 8XQ
Tel: 01743 261055

A Renal Dietetic service is provided to all renal patients at both Shrewsbury and Telford Hospital including predialysis, nephrotic, dialysis, acute kidney injury and transplant patients. Ludlow satellite unit is also covered.

This service is provided by 2 renal Dietitians: Marie Oakes and Abby Peat.

What is the role of a Renal Dietitian?

Renal Dietitians work closely with other members of the renal team including Consultants and Specialist Nurses. As your kidney function starts to reduce, waste products can build up in the blood e.g. urea, potassium and phosphate and you can also have excess fluid accumulate. This can make you feel unwell such as nauseous and lethargic.

The Dietitian will take into account your recent blood results, medical and social situation as well as your own food preferences and provide you with individualised dietary advice to help prevent the waste products building up in your blood. This can help to slow down deterioration to the kidney and can make you feel better. The diet will be tailored for you and every patient will have different dietary requirements, so what is advised for you may be different for someone else.

Doctors and health professionals will refer to eGFR (estimated Glomerular Filtration Rate). This is a test that is used to assess how well your kidneys are working. It is approximately a percentage of normal kidney function. If your kidney disease gets worst and your eGFR continues to decrease, your diet may need to be adjusted therefore the initial advice can change and will be continually reviewed. Written dietary information will be provided for you to refer to at home.

As well as restricting certain foods, we also provide support for:

  1. Patients with a reduced appetite who may be unable to meet their nutritional requirements and maintain their weight
  2. Patients trying to lose weight
  3. Ensuring patients can achieve a suitable protein intake
  4. Managing fluid balance
  5. No added Salt diet
  6. Understanding their blood results and relevant medications

Dietary advice can change depending on your clinical condition, stage of kidney failure and biochemistry.

Dietetic Cover arrangements:

Shrewsbury renal unit: Marie Oakes
Princess Royal Renal unit: Abby Peat
Pre dialysis / low clearance clinics: Abby Peat
Home Haemodialysis clinics: Marie Oakes
Peritoneal Dialysis clinics: Abby Peat
RSH Renal ward and outliers: Marie Oakes
Ludlow Renal Unit: Patients seen in outpatient clinics.

Contact Details for the Renal Dietitians

01743261358
Fax: 01743 261053
sth-tr.renaldietitians@nhs.net