home hemodialysis

[Lil609]

I need tips on finding a caregiver to administer at home dialysis for my mother in law.

[KidneyCoach NKF Ambassador]

Any caregiver would need to have had full training for the exact machine your mother in law uses. She also needs to be trained in doing cannulation, lab draws etc. It's a big deal to find someone who will do all this and sit with patient during treatment. Is there any family member or friends willing to fill the position? Are you planning on paying a caregiver a good compensation for this highly-qualified role? Blessings

[Bassetmommer]

Well, this is a tough one. You do not say whether she is going for PD or hemodialysis. If she is doing PD, she might be able to do this on her own. Hemodialysis does require a support person.

First of all, Medicare does not pay for dialysis support that I know of. However, they do pay for home health care to an extent. I am not sure where you live and so I can only speak of my area. The issue is, they will pay for a home health aide for recovery, and certain health conditions. Her doctor has to qualify her for home care. It is not easy. She has to score a certain level of not being able to take care of herself with daily processes like getting dressed or bathed. But here is the rub, home health aides are not qualified to do dialysis care. That would need a nurse level..... and good luck with that. There is such a terrible shortage of home care nurses, well nurses in general. However, the company you are going to use for home dialysis might allow having just the aide as a companion for your mother and let her do the dialysis. (I doubt it, but maybe). The only true hope for now I could suggest is private pay nurse. And it will be costly.

Again, depending on where you live, see if there is a dialysis center that you can contact and see if they first of all support home dialysis. Not all do. And then see what if any support they can offer. Do not expect much as they are also swamped and short staffed. The next step, if you decide to go with private pay is to find out if there are any home care services available for your mother. If that fails, you might go to social media, like a local neighborhood group to see if you can find anyone who does private pay care. Can be risky for sure so you have to vet them out.

Lastly, again, depending on the company that is doing home dialysis, see if you can just get someone in the neighborhood to sit with her during treatment. I do not guarantee that you will either find someone unless you offer a stipend and the company will allow it. Both people will have to be trained. The thing I see in your post that will stop this idea is that you are asking for someone to administer the treatment. Go back to what I said about nurses......

Good luck.

[KidneyCoach NKF Ambassador in reply to Bassetmommer]

Home hemodialysis does not require a support person. This is a requirement mandated by certain clinics - only. FDA has approved SOLO home hemo, but clinics may require a support person. I know many currently doing home hemodialysis SOLO. I've had home health several times and none of the nurses or aides have even heard of home dialysis, none trained. It's possible to find a traveling dialysis nurse or PCT to administer HHD however it would require private insurance or out of pocket pay.

Wish I had more answers. Legislation to allow payment for care-partners who help administer home dialysis is in the works. Most nephrologists don't know how to set up a dialysis machine...which qualifies HHD care partners and patients in something over doctors. LOL

Blessings

[Bassetmommer in reply to KidneyCoach]

Hey

KC, if you read my post, I said in my area and they DO require support person. NO getting around it here. And if you can get a private pay nurse trained with the company they can do the treatment.

[KidneyCoach NKF Ambassador in reply to Bassetmommer]

I do apologize for my misspeaking. I only know of quite a few hhd persons who got through the "requirement" by using FDA approval in defense. That being said many clinics are hard-core against SOLO regardless. Again, my apologies. Blessings

[Bassetmommer in reply to KidneyCoach]

No need for apologies. When I saw what you wrote, I went to the University of Google and you are correct. They do allow solo HHD in some places. I was shocked but thrilled. Seems my area is still back in the stone age on so many things.

[bumblebee_tuna in reply to Bassetmommer]

I think it depends on the size of the clinic and how much home dialysis do they support. My clinic does both PD and Home Demo, they already have more Home Hemo now than PD patients, many of them are solo.

Edit: Nocturnal Home Hemo always requires a caregiver.

[Darlenia in reply to bumblebee_tuna]

Solo HHD scares me. Last year, a woman reported in a FB group that her hubby hemorrhaged, apparently while napping, when she was away at work. She found him deceased with blood pooled on the floor. You've got to stay awake, that's for sure, if you're doing it alone.

[LeesKees_NJ in reply to Bassetmommer]

I do solo home hemo, it is not for the faint of heart. It took 6 weeks to be certified. It's a lot of work to maintain the machine and give yourself treatments. You have to do it more often when doing it at home, too. The machines are not a strong, their much smaller than the center units.

[Bassetmommer in reply to LeesKees_NJ]

Yes that was what I was told too. 6 to 8 weeks of training and that more often and shorter times. Perfect for me and easier on the old body.

[Darlenia]

All good information submitted by others. Maybe also check with the Area Council on Aging closest to your mom. They often have excellent info on resources in the immediate area. I hope you find an outcome that works well for both of you.

[checkman]

You can do home hemo solo. This is a recent change. DO NOT FORGET ABOUT ALL THE SUPPLIES/HEAVY BOXES/GETTING RID OF ALL THE BOXES THAT YOU HAVE TO DEAL WITH IF YOU LIVE BY YOURSELF. If you do have a partner/home aid they will be trained (possibly certified) by the dialysis center just like PD training is provided. You do not need a nurse to help with home hemo, just a partner/aid that is trained by the center. When I was on PD I had to see my Neph once a month in the office for labs, etc. (my Dr. drew blood himself for me) I don't see that trip once a month changing on home hemo. Your partner/aid does not need to do lab draws, go to a lab. I also gave myself iron shots once a week.

Treating Water for Home HD

The first step in treating water for home HD is ensuring that your feed water (coming into your home) meets EPA drinking water standards. Your center may ask you to bring in a sample of your water for testing (I would get it tested by a 3rd party testing facility, I would NEVER trust the dialysis center to do this). If it fails the tests, you may need to use bagged dialysate (i.e., NxStage®) instead of treating your water (MORE HEAVY BOXES). Once your water is known to meet the EPA standards, you'll need a way to remove bacteria, chemicals, and metals.

FACT: EPA STANDARDS FOR DRINKING WATER ARE VERY LOW I WOULD NEVER TRUST YOUR DRINKING WATER! You can go to EWG.org and see all the chemicals in your tap water by zip code/company. YOU WILL BE SHOCKED!

Home health aid covered by Medicare (from Medicare.gov): Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services as long as you need part-time or intermittent skilled services AND as long as you’re “homebound,”

medicare.gov/coverage/home-...

If you're not homebound you have to get Medicaid. Medicaid covers home health aids. You can get Medicaid if you make too much money by using a pooled trust. I have 2 friends that use a pooled trust. There are lawyers that do this specific process for a living.