End-of-Life Care in End Stage Renal Disease: Integration of an advance care planning process

This study is exploring how to better include advance care planning — conversations about end-of-life wishes — into the care of people with end-stage kidney disease. It involves patients who are approaching the need for dialysis, or who have just started dialysis, and their main family caregivers. The goal is to see whether structured planning conversations reduce distress and improve care. You may be eligible if: - You are 18 years of age or older - You have severe chronic kidney disease and are expected to need dialysis within 12 months, OR you have just started dialysis (hemodialysis or peritoneal dialysis) within the past month - You are able to understand and complete questionnaires in English - You are mentally able to give informed consent - OR you are the primary family caregiver of such a patient, age 18 or older, and able to read and write in English You may NOT be eligible if: - You do not meet the above criteria Talk to your doctor about whether this trial might be right for you.