Hemodialysis uses an external filter called a dialyzer to clean the blood and remove excess fluid. Blood is pumped from the body to the dialyzer and returned to the body by a dialysis machine, which tracks the speed and safety of the treatment. It can be done at a dialysis center, or at home. For detailed information on dialysis treatments, visit the Home Dialysis chapter in the
Late Stage Choices section of this program.
Most home hemodialysis programs require the person receiving treatment to have a care partner who is willing to help during each treatment. Treatments typically take from three to three and a half hours, including setup and cleaning up after treatment. While it’s good for the person being treated to manage many, if not most aspects of treatment, you’ll be assisting in some way, every day. You may help with inserting the needles and checking blood pressure while treatment is underway. Of course, if a problem or an emergency arose, you would be the person to call for help. You may also provide other help, like setting up the dialysis equipment, keeping track of and ordering dialysis supplies, cooking, attending check-ups, running errands, and picking up medications. One of the most important ways you’ll contribute is by offering your love and support.
If you become a home hemodialysis care partner, you’ll make a significant contribution to your loved one’s quality of life. Your presence means they can dialyze in the comfort of home. In addition, home dialysis makes it possible to dialyze more frequently or for longer periods of time, which is associated with many medical and lifestyle benefits.
Even people who choose home hemodialysis sometimes have in-center dialysis every so often, just to give their care partner a bit of time off. Click on the chapter on Care Partner Self Care for more information on respite options.
Pop-up: When a caregiver is necessary
Someone who is very frail, obese, not mobile, or who is suffering from cognitive impairment may need total care. Medicare does not pay for home dialysis helpers. If it is easier for your family to care for a very high-needs loved one at home than to bring him or her to and from a clinic three times a week, you would be doing all of the work.
Most home hemodialysis programs (and a few peritoneal dialysis programs as well) require a partner to go through training with the person on dialysis. Training time is determined by how involved you will be. Home hemo training will take about 4 hours a day, 5 days per week, for 4 to 8 weeks, to achieve competence. But it’s vital to be clear from the start what your role will be, and how much you will do, versus the person in treatment.
Starting home dialysis is like bringing home a new baby. You lose some control until you set up routines. There are things to find room for and new tasks that need to be done. It’s hard and very stressful at first! And then things get easier as you get used to them.
Talk with your partner and the home training nurse about what to expect. And give yourself time to adjust. One care partner suggests clearing your calendar during training, so that for a short while, you need only focus on learning these new routines.
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