Home Haemodialysis

  • Reference Number: HEY-920/2017
  • Departments: Renal Service

Introduction

This leaflet has been produced to give you general information about Home Haemodialysis.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What are the benefits of home haemodialysis?

Home haemodialysis allows you to be more independent and flexible to fit dialysis around your everyday life.  You will also be able to dialyse more frequently at home, perhaps daily or on alternate days, which will mean being able to dialyse for shorter periods of time.  This could reduce your dietary and fluid restrictions and reduce travelling to and from hospital.  Home therapy requires you to be willing and able to take responsibility for your treatment with support from the renal team.

How do I know if I am suitable for home haemodialysis?

To be considered for home haemodialysis your consultant must be in agreement and you must:

  • Learn the dialysis process and complete your training including the operation of the equipment
  • Ideally have a carer/carers who have made an informed decision to assist or be with you during the haemodialysis process
  • Have a well-functioning vascular access (fistula, graft or line)
  • Have an area where plumbing and electrics can be adapted for home haemodialysis, eg a spare room or part of a room
  • Be free of complications that would make home haemodialysis unsuitable or unsafe for you
  • Be willing to sign a patient contract outlining the patient, Trust and Fresenius responsibilities for the duration of home haemodialysis.

What do I do next?

If you are interested in home haemodialysis and want to be considered for this treatment option, please ask the nurses caring for you and they will discuss your suitability with your consultant.  If you are considered suitable for home haemodialysis, a letter of referral will be sent to the home dialysis nurses.   They will contact you to arrange an appointment for a home assessment.  This includes discussions about the training, financial allowances, ongoing support and what you can expect with adaptations so that the water treatment and machine can be placed in your home.   It will also include how you will manage stores and equipment etc.

What happens after the assessment?

A member of the building contractors will contact you to arrange an appointment at your home to discuss and plan the dialysis conversion requirements.  When the home conversion work has been agreed an estimated date for starting the work will be discussed with you.

How will I be trained to do my dialysis at home?

Shared Care training is started in the unit where you have your dialysis.  Your nurse will provide you with a training and education competency booklet and the home haemodialysis resource package, which you can work through with the nurse at your own pace.  When you are able to perform dialysis by yourself and your home has been adapted for dialysis, arrangements will be made by the home dialysis team to support you with your ongoing treatment.

What support can I expect at home?

Initially you will be visited by the home dialysis nurse more frequently but the aim is for you to be able to manage this yourself.  You will be visited regularly to be given ongoing support and discuss your dialysis prescription and any related problems.  Technical support is also available 24 hours to assist and advise you with machine problems should they occur.  There may be times when you may have problems and may need to return to your local unit for dialysis.

You will also be referred to a Renal Social Worker who will be able to provide advice on any state benefits that you might be entitled to.  Contributions towards utility bills are currently made; this is reviewable annually.  You may also be able to claim for a reduction in your council tax.

Arrangements will be made for your local council to collect clinical waste weekly and further supplies for home dialysis will be delivered on a regular basis.

Respite Care

The renal service recognises that the patient and carer may on occasion need to have a break from home haemodialysis.  Providing resources are available, arrangements can be made for you to have your dialysis at the nearest unit to your home or in the main unit in Hull.

Patients’ Comments

  • “I feel more in control of my life, organising my dialysis regime to suit my lifestyle”.
  • ”I never thought I would ever be able to insert needles into my veins but after being taught how to, I can’t imagine letting anyone else do it for me, I also feel a great sense of achievement”.
  • “I have more energy since starting daily dialysis and have time to socialise more with family and friends”.
  • “Sometimes I miss the company of the staff but I still prefer to have my dialysis at home and I have joined the local Kidney Patients Association to keep me in touch with patients and staff”.
  • “It was a little daunting the first time we dialysed with no visit from the nurse, but we coped and soon dialysis was just part of our daily routine”.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact any of the following:

Haemodialysis Unit:  (01482) 608758; Pre dialysis Nurses: (01482) 675093; Home Dialysis Team: (01482) 608704

Organisations:

  • Humberside Kidney Patients Association
  • National Kidney Federation
  • British Kidney Patient Association

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.