Building a Community in the Home Setting

People with kidney failure on home dialysis may experience additional benefits compared to those treated in-center, yet many patients still choose in-center dialysis.

Over the last 10 years working with dialysis patients, I have seen the benefits of home dialysis, and I encourage more people to choose home. Peritoneal dialysis (PD) and home hemodialysis (HHD) give people greater flexibility in their schedule and diet. Many home patients also report that they have more energy and overall feel stronger.

Yet, I know the significant emotional and mental barrier is one of the biggest obstacles to overcome while making the decision to transition to home dialysis.

Years ago, I was reviewing a Kidney Disease Quality of Life assessment with a patient. We spoke about decreased energy levels, the stress of fluid and dietary management, and emotional concerns related to their personal life. I knew that home dialysis could help this patient better manage their challenges.

However, the patient felt incapable of doing what their care team does during treatment and questioned how they were supposed to learn what trained medical professionals do. After speaking with many patients over the years, I've learned many feel intimidated and overwhelmed by home dialysis.

To ensure that patients feel confident and competent enough to transition to home therapy, I saw the need to continue to provide more hands-on education in our centers, so, I worked with my local leadership to bring more education into my centers.

We introduced educational and experiential opportunities like exposing patients to using home hemodialysis. We found that when other patients could see what home hemodialysis looks like (while they are at treatment), the idea of home therapy becomes less overwhelming.

In one of our centers, we've implemented group learning opportunities, which has created a sense of community for patients considering a transition to HHD that more closely mimics the in-center setting.

We are working to expand these group learning opportunities while keeping with COVID-19 protocols. We have the potential to educate more patients considering a transition to HHD in a location where everyone feels safe and comfortable. When learning together, people form a connection with each other and find comfort in being around other people who share the same challenges.

Additionally, having multiple people learning about home dialysis in one setting can also provide opportunities for the social worker, dietitian, and physician to speak to everyone at once, balancing the need for efficiency with that of community support.

Educating people about dialysis treatment options empowers them to take control of their treatment at any point in their dialysis journey. While improvements and new ideas are ongoing, it's important that we highlight the steps to build a home community for both our patients and our staff, and to make sure that all patients have the information needed to choose the best treatment option for them.