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By Courtney Mawhinney, R.N.
Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.
As interest in home dialysis as a treatment option for chronic kidney disease (CKD) continues to increase, I often get questions from concerned patients about what it takes to be a successful candidate for home dialysis.
Every patient has unique medical and lifestyle needs that help determine the best course of treatment on a case-by-case basis. Generally speaking, the most successful candidates for home dialysis are those patients who are dedicated and want to take control of their treatment, keep working full-time or maintain a flexible and active lifestyle.
As with in-center dialysis programs, home dialysis patients continue to work closely with their doctors and healthcare team that monitors and oversees their ongoing care just as they would if they visited a dialysis center for their treatments. Because they have more flexibility in managing their treatment, home dialysis patients tend to see a positive impact in their ongoing care as well as how they live. There are, however, a few key factors that can help determine a patient’s overall success with home dialysis treatment.
As with all forms of dialysis or other medical treatments, safety should always remain the top priority for anyone on home dialysis. All home dialysis patients and their care partners participate in customized training programs to teach them how to safely administer their own treatments and address potential issues or problems that might arise. Patients are sent home only when the nurse is confident that patients and his or her care partners can initiate, monitor and complete their home treatments with confidence. Once you’re home, your doctor and nurse will monitor you closely to make sure you’re getting the support and clinical care you need. Home dialysis patients should keep information about their treatments, a set of emergency numbers and a phone nearby in case of an emergency.
Even though home dialysis allows patients and their care partners to conduct treatments in the comfort of their own home, and permits some flexibility with the treatment schedule, adherence to the prescribed treatment time including dialysis time, diet and medications is important. Your involvement in your own care will empower you to influence the quality of your life each and every day.
Home dialysis patients are in the driver’s seat for their own care, and do best when they have a strong commitment to effective time management. The most successful home dialysis patients are those who learn how to integrate their treatment schedules seamlessly into their daily lives and routines. Your physician will tell you how many days a week to dialyze and for how long, but from there, you are free to arrange your time and schedule it around other obligations.
For people already juggling complicated schedules, adding home dialysis into the mix isn’t so difficult strategies are put in place to optimize time. By making sure to prepare equipment and supplies to be ready when they are, many patients find it easier to comply with the number and duration of treatments prescribed by their physician. Some patients find it helpful to develop a weekly calendar to keep track of treatments.
Patients who are considering home dialysis should know how this treatment can affect their living spaces. Some types of home dialysis require a dedicated place to perform treatments. If you do peritoneal dialysis (PD) at night, you can sleep in your own bed. If you choose home hemodialysis (HHD), you will need an appropriate chair. PD does not require a special chair.
Space is also needed for equipment and supplies. Different types of home dialysis require different equipment and supplies, so it’s important to talk about the different options with the healthcare team.
Most importantly, patients should set things up in a way that is easiest and most comfortable for them. Envision what you see yourself doing when you dialyze and then find a way to incorporate your equipment and supplies into that vision. Maybe you have a great view from inside your home and want to look out the window, or maybe you want to watch television—every patient is unique, so make sure you find a solution that fits you.
Dialysis care partners often play a key role in providing both emotional and physical support for home dialysis patients. That’s why it’s recommended that patients proactively explain the process to family and close friends to help put them at ease.
It’s important for patients to be sensitive to the needs and schedules of the family member or friend fulfilling this role. Sometimes adhering to a rigid treatment schedule can create stress for you and your dialysis partner, so it’s especially important to find a balance for your respective roles and responsibilities related to your treatment that works for both of you.
Courtney Mawhinney is a Registered Nurse and has worked with DaVita for the last 8 years. She has worked in the home dialysis field for 6 years and started one of the first DaVita home hemodialysis programs in Philadelphia, PA. This home location has trained over 100 home hemodialysis patients. She is now working as the director of clinical marketing for DaVita Home Dialysis.
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