Quality Dialysis

Advantages

One of the main advantages to providing dialysis in the home is increased comfort and safety for the patient. Being in a familiar environment decreases apprehension in patients, Barclay found. “During the dialysis experience itself, they learn more when they are at home,” she added. “It eliminates transportation problems, and it eliminates the problem of a family having to take a loved one back and forth to dialysis. It’s private, one-on-one care, so there are educational advantages, too. When you have that one-on-one care, patients learn more.”

Patients may even be more compliant with diet and medications, because the nurses can observe them more closely, Barclay pointed out.

However, the service does have its disadvantages. For example, not every patient has private insurance. Additionally, home dialysis is not something that’s well known in the renal community except in the state of Texas, Barclay said. “We only do it in Texas right now, but we’re hoping in the future to change that. There are so many patients who could benefit from this program,” she added.

Quality Dialysis does offer traditional dialysis services, and some patients are allowed to do self-dialysis. The company can train patients at home, so they do not have to visit a center to be trained. “It’s the total home modality network,” Barclay added. “We can train you in your home, vs. going in center, if you choose to do self-dialysis. We also provide peritoneal dialysis (PD), and nocturnal dialysis.”

Patients providing their own home dialysis isn’t as odd as it may sound. They receive a great deal of education before they are allowed to begin. “For those who do it on their own, when they are trained, they are certified by us that they are doing it right,” Vargheese explained. “Then, once they are trained, there may be infrequent visits [to ensure they are doing it properly].”

But regardless of whether they do it themselves or with the help of a nurse, patients are delighted to have the option to dialyze outside of the clinic. “If you look at the calls and the patient’s comfort, the patients are very keen to have dialysis at home,” Vargheese offered. “They don’t have to travel. In a home setting, they feel much better because it’s a setting they are used to. Some of these patients work, and some travel, so they set it up according to their schedules. We try to work with the nurse and patient schedules so the nurses who dialyze have some fixed times when they are available. But a lot of patients get some flexibility. Some patients do not. Recently, we had a patient who wanted to be dialyzed at 4 in the morning because he travels -- which we couldn’t do. To some extent, there is flexibility, but not a lot,” he added.

Who Can Use Home Dialysis?

Some patients might not seem ideal for home dialysis, such as those with dementia or an uncontrolled comorbidity, but, Barclay countered, “These are the patients who are perfect for the home program, in that they wouldn’t allow the disruptiveness in an ESRD facility. You have more control.”

“There is a certain group of patients who may have problems with home dialysis; especially if they are really restless or very disoriented, or too sick, they may have problems,” Vargheese added. But ultimately, it will work for most patients. “We have done staff-assisted dialysis in nursing homes and different type of assisted living, where they get another type of nursing care, and we could dialyze in that setting,” he added.

Really, Barclay suggested, home dialysis is ideal for any patient as long as his or her coverage allows it. Some patients have been on home dialysis for 10 years. And many more patients can benefit from it now, as the market continues to grow.