Get Engaged! It’s YOUR Life! Modality Calendar (2).pdfGet Engaged! It’s YOUR Life! Life at Home...

Get Engaged! It’s YOUR Life!

Life at Home Patient Engagement Calendar

Home Modality Patient Engagement

Question #1

Did you make a list of questions to ask your doctor about a

home referral?

January Take part in your life ask your doctor about home therapy

It’s YOUR life

February Participate in a home modality

presentation

Knowledge is POWER

March Ask your facility about different

home modality treatments

Myth Busters

April Did you know a home therapy

program can give you more time for personal activities?

You can travel!

July Did you know about HHD and

PD treatment.

What is best for you?

October Medicare Coverage

Lets Talk!

May Home Therapy Services

Your facility is here to help!

August Home therapy is a great way to

Stay Cool at Home!

November Save time with treatment with

HHD/ PD

Time for Turkey!

June Plan ahead for emergency

at home

Be Safe!

September Stay warm at home

Winter is coming!

December Home Sweet Home

Happy Holidays from Home


Question #2

Did you attend at least one home modality presentation


Question #3

Do you know about your treatment options?


Question #4

Do you know the benefits of home therapy?

Did you get your home modality patient engagement handout this month?

If not, ask your facility staff or Facility Patient Representative (s) for more information on this month’s topic!

This Calendar was created BY ESRD Network of Texas FOR ESRD patients!

To file a grievance or for questions, contact Network 14 at 1-877-886-4435(phone), 972-503-3219 (fax), [email protected] (email),

10 Tips to Help You Become Active in Your Care!

1 KNOW YOUR CARE PLAN.It’s your road map to better health. Your care plan is created every year by you, your doctor and the dialysis staff. It contains medical, nutritional, and social goals specific to you. Request a copy of your care plan and save it with your medical records.

2 ASK QUESTIONS.Find out what your medications do for you, how well dialysis is cleaning your blood, why certain foods are bad for you, and what foods are best.

3 KNOW YOUR DIALYSIS OPTIONS.Did you know there are different ways to dialyze? Some options even allow you to dialyze at home. Some may suit your needs better than others, like helping you work or go to school. Ask and find out.

4 KNOW YOURSELF.You know your body better than anyone else. If you don’t feel well after taking some medications, tell the doctor and the staff exactly how you feel. They need your feedback to make your care plan work for you.

5 NOTICE TRENDS. Is your blood pressure high lately? Are you cramping more? Having trouble sleeping at night? These things could indicate that your care plan should be adjusted. Tell the staff about them.

6 EDUCATE YOURSELF. Don’t be shy or afraid to ask your care team to explain medical terms in words you can understand. Ask where you can get more information about medical issues that might affect you. They are important!

7 SPEAK UP.You are the star of your care plan meeting. Don’t be shy. Be heard! The more you take part in the meeting, the more you will benefit.

8 YOUR APPOINTMENT IS IMPORTANT This meeting is focused entirely on your health and how to improve it. Your medical team is there to help you, so if you are unable to keep your appointment, let them know in advance and reschedule as soon as possible.

9 DECIDE TOGETHER.Make sure you understand what each part of the care plan means and how it will affect your health. You will be asked to approve the decisions the doctor and staff make, so you need to understand every part.

10 YOU DON’T HAVE TO GO ALONE.It’s okay to bring a loved one, a family member, or a good friend to help you ask questions and understand the answers. Under special circumstances, they could go in your place, but of course it’s best for you to be there and actively participate.

Prepared by the National Patient and Family Engagement (N-PFE) Learning and Action Network (LAN), under the ESRD NCC. The ESRD NCC gratefully acknowledges HSAG: End Stage Renal Disease Network 18 of Southern California for development of the content used in this resource.

This material was prepared by the End Stage Renal Disease (ESRD) National Coordinating Center (NCC) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services under CMS contract: HHSM-500-2013-NW002C; and was adapted by the contractor under CMS contract #: HHSM-500-2016-00007C. The contents presented do not necessarily reflect CMS policy nor imply endorsement by the U.S. Government. Publication Number: FL-ESRD NCC-7N1T02-09022016-08

End Stage Renal Disease National Coordinating Centerwebsite: www.esrdncc.org

www.facebook.com/esrd.ncc @esrdncc

• e-mail: [email protected]

Uncovering Myths About Home Dialysis

Myth vs. Reality

Patients and care partners have reviewed this booklet from their perspective to help you better understand, and potentially make, the personal choice to dialyze at home.

A special thank you goes to End Stage Renal Disease (ESRD) Networks 16 and 18 for originally creating the content and providing the opportunity for the Home Dialysis Affinity Group National Patient and Family Engagement Learning and Action Network (NPFE-LAN) Subject Matter Experts (SMEs) to review, enhance, and re-package it from the patient and care partner viewpoint.

What are the ESRD Networks?Eighteen ESRD Networks, organized regionally, serve as liaisons (or links) between the federal government and the providers of ESRD services. The ESRD Networks advocate for quality care for kidney disease patients. To contact your ESRD Network, visit www.esrdncc.org.

What is the NPFE-LAN?The NPFE-LAN, which is part of the National Coordinating Center (NCC), partners with patients and family members (called SMEs) to enhance national quality improvement initiatives. This is accomplished by bringing together patients from all 18 ESRD Network regions to discuss and achieve patient-led goals. The NPFE-LAN includes patients, family members, and care partners who come together on a regular basis to provide the patient perspective about efforts to improve quality of care designated by the Centers for Medicare and Medicaid Services (CMS).

If you would like to learn more about becoming involved on a national level and making an impact on quality improvement initiatives, please contact your ESRD Network or visit www.esrdncc.org/npfe-lan.

2 | Uncovering Myths About Home Dialysis

What Members of the Home Dialysis Affinity Group Say About Their Involvement with the NPFE-LAN• It’s impressive

how the patient experience is included.

• Making a difference is impactful.

• Being involved adds to knowledge.

• It’s important to have a voice for yourself, as well as fellow patients.

• Our involvement enhances quality improvements.

General Information Hemodialysis (HD) and Peritoneal Dialysis (PD) Home Modalities

Myth RealityYou must buy the dialysis machine to use at home.

Your dialysis clinic will provide the machine if you need one for home use, as well as the supplies.

You can’t just decide to do dialysis at home, right?

Anyone on your care team at the dialysis center can refer you, or you could ask them yourself!

Once you decide to do dialysis at home, you can begin right away.

There’s a lot to learn and arrange for when preparing for home dialysis. But you can get started by first speaking up.

If you do dialysis at home, you won’t be able to change dialysis types or be a candidate for transplant.

Not at all. You can always switch to another home modality or decide you’d like to go to in-center hemodialysis. Also, doing home dialysis does not make you less likely to receive a transplant.

If you do home dialysis, it costs more than at the dialysis unit.

No, not at all. Both Medicare and private insurance cover the cost of home dialysis.

You can’t dialyze at home if you are non-compliant in the dialysis center.

Each individual will be evaluated, but those with a high need to control situations may actually do better at home.

If you do home dialysis, your home must be rewired.

Any required electrical work, if needed, is simple and can often be completed sometime during the training.

You can’t do home dialysis unless your plumbing is redone.

It depends. One option uses an adaptor that fits onto the faucet. The other option may require some minor plumbing work to be completed.

You can’t do home dialysis if you are afraid to insert your own needles.

Many patients have learned how to self-cannulate (insert their own needles) both for in-center and home dialysis. It can preserve the fistula, hurt less, and result in fewer complications. Patients with a specific kind of fistula (an AV fistula) can use a buttonhole technique, which uses dull needles placed into the exact same hole every time you have dialysis. Ask your nurse to learn how.

You must get rid of your pets to do dialysis at home.

Lots of people dialyze at home and still have pets. Clean well and ensure your pets stay out of the room when you connect or disconnect.

When you dialyze at home, you can eat and drink whatever you want.

Dietary and fluid intake limitations remain in place, but you may have a bit more flexibility with your limits and choices. Always check with your medical team when changing your renal diet.

What patient members of the Home Dialysis Affinity Group say about choosing home dialysis…• Flexibility and convenience of setting their own treatment schedule • Choosingatreatmentwiththeirdoctorthatbestfitstheirlifestyle• Less strict dietary limits when dialyzing at home

Uncovering Myths About Home Dialysis | 3

Peritoneal Dialysis (PD)

Myth RealityYou’ll get an infection! Very low rates of PD infection are possible when close attention

is paid to the causes of peritonitis (an infection of your abdomen), along with training provided to patients on the procedures used to reduce the risk of infection.

If you had previous abdominal surgery, you can’t do PD.

Routine abdominal surgeries, such as hernia repairs, C-sections, and some transplants, do not prevent PD as an option. Your doctor and surgeon will help you evaluate your options.

If you have vision or hearing problems, you can’t do PD.

Assist devices are available to help with most tasks involved in doing PD.

You need to have some kidney function to do PD.

Kidney function will always be checked, but PD can be done without any kidney function.

If you are overweight, you can’t do PD.

A catheter placed differently into your abdominal cavity may be a better option. PD can still be done.

You need to have a lot of space at home to do PD.

You do need some space for PD, but many people who live in efficiency apartments, trailers, and other small spaces find a way to make PD work if they want it.

Only one kind of PD is available. While all PD involves having a special fluid in your abdomen, you can choose how to handle the process, for example, manually or automated (while you sleep).

When you do PD, you are free to take either a bath or a shower!

A bath is not permitted unless you have a pre-sternal catheter placement. A shower is permissible, and you will be taught how to care for your catheter site after your shower.

When you do PD, you cannot go swimming.

It all depends where you are swimming. Swimming in a lake, pond, river, ocean, or non-chlorinated pool would not be OK because it increases the risk of infection. Generally, swimming in a chlorinated pool could be OK. Always check with your healthcare team first.


Home Hemodialysis (HHD)

Myth RealityYou won’t have any experts at home to help.

You will learn to be an expert. Plus, your home dialysis facility serves as 24-hour phone backup. You will always be near help.

You could bleed to death very quickly.

No one has ever bled to death on HHD. Machine alarms alert you to the detection of just one drop of blood out of place. You will have time to react and fix the problem.

HHD is a huge burden of extra work for a care partner.

It is best if you do as much of our treatment as you can. Some people do HHD without a care partner.

An HHD care partner needs to have a medical background.

Nope, no medical background is needed. The clinic will train you and a partner (if they require one, a care partner is not always needed).

You can’t do HHD with a dialysis catheter.

Some programs allow HHD with a catheter. It is best to trade your catheter for a vascular access due to higher infection chances.

Your house must be perfectly clean at all times.

Your home does not have to be perfectly clean to perform hemodialysis at home.

If you do HHD, you must follow the same scheduled days of the week.

Many different schedules are available and can be arranged at home. For instance, short daily dialysis or extended dialysis. You might also consider nocturnal dialysis if you’re interested in dialyzing while you sleep. The purpose of home dialysis is to set your own schedule.

You can’t get training to do your dialysis at home right from the beginning.

There must be time for evaluation and practice. Everyone is a little different; both you and staff must be comfortable with your skills.

There’s a long waiting list to learn how to do HHD.

This varies among facilities offering a home program. Ask your nurse to be certain.


Is It for Me?You’ve had the opportunity to review and uncover some of the common myths related to home dialysis modalities. Now, is an opportunity to consider if this is the right treatment option for you.

Why should I consider home dialysis?• More flexibility in my dialysis and daily life schedules• More normal diet with less restrictions• May be able to reduce medications• Less transportation hassles getting to and from a clinic• Ability to travel more (depending on your capability with

bringing the machine and supplies)• I’m interested in managing my own care• I’d like more energy, both mentally and physically• I could have better control of my blood pressure• There would be less stress on my heart and less recovery

time after treatment

What type of support would be provided by my dialysis facility?

• The Home nurse will provide one on one training until you are comfortable to dialyze at home.

• Your clinic will be available to you 24/7 either in the facility or by phone.

• You will still have visits to the home facility for labs and evaluations.

• The Home nurse will assist in organizing your home with supplies needed for dialysis.

If you would like to learn more about a home modality option for you, take the next step, research the best options for you and talk with your care team.


Seven Tips Patients Have About Choosing a Home Modality

1. Research your many options.

2. Think about your long-term goals.

3. Involve your care partner in the preplanning process.

4. Consider how you can add home dialysis in your living space.

5. Ask to speak with a patient who is dialyzing at home.

6. Discuss any questions you may have with your healthcare team.

7. Form a partnership with your care team.

Conversation StarterBelow are a few sample questions to start your discussion:

1. I’d like to talk to you about being considered for home dialysis. Where do I start?

2.Whatarethebenefitswithdialyzingmorefrequentlyathomeandwhatare the choices that are best for me?

3.Howlongdoesthetrainingtakeandwhatdoesitentail?

4.DoyouhaveavideoIcanwatchoraweblinkformoreinformation?

5.CanItalktoapatientwhoisdialyzingathome?

Add your other questions below:


Crea

ted

by

Patients for PatientsHome Dialysis ResourcesBelow is a listing of websites and resources providing you additional information about home dialysis.

Home Dialysis-Related

MyDialysisChoice.org—www.mydialysischoice.orgA program of the non-profit MEI, the “My Life, My Dialysis Choice” website, offers an interactive tool to help you choose the right treatment for you, so you can feel your best AND live the way you want to.

Home Dialysis Central—www.homedialysis.orgA program of the non-profit MEI, the Home Dialysis Central website offers information and education about all types of dialysis.

Home Dialyzors United—www.homedialyzors.orgHome Dialyzors United, a non-profit patient organization, is the only dialysis patient organization dedicated to the home dialysis community.

Alliance for Home Dialysis—www.homedialysisaliance.orgThe Alliance for Home Dialysis promotes activities and policies that will facilitate treatment choice in dialysis care, while identifying and addressing systematic barriers that limit access for patients and their families to the many benefits of home dialysis therapy.

Renal-Related Organizations

American Association of Kidney Patients—www.aakp.orgAmerican Kidney Fund—www.kidneyfund.orgEnd Stage Renal Disease National Coordinating Center—www.ESRDNCC.orgNational Kidney Foundation—www.kidney.orgKidney Patient News—www.kidneypatientnews.org

A special thank you to the Patient and Family SMEs of the NPFE-LAN. Their expertise, compassion, anddedicationtomakinganimpactforalldialysispatientsisreflectedinthiseducationalpiece.FromMarch–September 2018, this group of individuals, located across the country, met by conference call monthly to discuss, enhance, and create this toolkit. Without their partnership and engagement, this resource would not exist as it does. We truly appreciate their input.—ESRD NCC

3000 Bayport Drive, Suite 300, Tampa, FL 33607 | 1.844.472.4250 | 813.354.1514 fax | www.esrdncc.org

This material was prepared by the End Stage Renal Disease National Coordinating Center (ESRD NCC) contractor under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy not imply endorsement by the U.S. Government. FL-ESRD NCC-7N21A1-08292018-01

EYEBROW TEXTDIALYSIS TRAVEL

Traveling with dialysis Use this travel checklist to help with what to pack and how to plan before taking a trip.

Medical supplies MedicationsPack enough of each medication to last you through your trip, plus a few extra days’ worth in case of an unexpected delay.

Home dialysis supplies Make sure you pack everything you’ll need for treatment, and bring a few extra days’ worth. Ask your dialysis nurse if you have questions about what to take—and discuss airline guidelines for traveling with medical equipment and solutions if you’re flying.

Did you know? If you’re doing dialysis with us, we can ship at-home dialysis equipment to your travel destination in advance. Contact our Fresenius Kidney Care Patient Travel Services at 1-866-434-2597, and we’ll take care of it.

Other medical suppliesMake a list as you run through your daily routine so you don’t forget anything you need.

Personal and medical informationBe sure to pack these essentials: Your ID card Your insurance card Medication and allergy lists Phone numbers and email addresses for your doctor and social worker Phone numbers, email addresses and location information for dialysis centers

you plan to visit Emergency contact information Dialysis treatment and kidney care instructions Phone number for Fresenius Kidney Care Patient Travel Services: 1-866-434-2597

KCTS000483-01 | © 2016, 2017, Fresenius Medical Care, All Rights Reserved.

w w w . H o m e D i a l y s i s . o r g

Conventional Daily Nocturnal In-center CAPD CCPD HHD HHD HHD HD

Need to visit clinic 3 times a week

Supply storage space needed

Infection is a risk

Can affect body image

Weight gain from dialysate

Limits swimming, tub bathing **** ****

Lack of privacy

A partner is needed

Takes several weeks of training

Plumbing/wiring may be needed

Conventional Daily Nocturnal In-center CAPD CCPD HHD HHD HHD HD

More-normal diet and fluids

More dialysis to feel better

Work-friendly treatment

Puts you in charge

You’re not around sick people

Fewer ups & downs in how you feel

Portable – take it with you

Flexible – suits your schedule

Available in every state * ** ***

Needle-free treatments

Have your days free

Learn it in a week or two

Fistula likely to last longer

* Except WY ** Except MT *** Except MT, ND, RI, SD, VT, WV, WY **** If dialyzing with a catheter

Home Treatments Compared: Pluses +

Home Treatments Compared: Minuses -

Emergency Preparedness Checklist and Tips

An emergency can happen at a moment’s notice. Act now and prepare before disaster strikes! This checklist will help you get started.

You’re not prepared if you cannot check these items on your emergency plan: My dialysis facility has the current street address and phone number(s) that they need to contact me and/or household member(s) or care partner(s).

I have discussed my emergency plan and my dialysis facility with my household members. Dialysis facility name: _________________________________________________

Dialysis facility address: _______________________________________________

Dialysis facility telephone number: ______________________________________

I have a back-up plan to get care if my dialysis facility is closed. Alternative dialysis facility: _____________________________________________

Alternative dialysis facility address: ______________________________________

Alternative dialysis facility telephone number: ____________________________

I have a copy of my current treatment prescription record. Current Dialysis PrescriptionTime on treatment: ______________________

Blood flow rate: ________________________

Dialysate flow rate: ______________________

Dialysate: __________________________

Treatment anticoagulation medication: _________________________

I have an additional medical condition:_______________________________________________

I check the items in my emergency kit every six months to ensure they have not expired and are working properly.

I review and update my emergency list at least every six months.

Use this list to help you build your emergency kit: � Prescription medications and list of medications � Insurance and/or Medicare Card � Current copy of monthly lab report � First aid kit � Bottled water � Renal diet friendly non-perishable food � Cash � Spare glasses � Manual can opener

� Warm blanket � Battery-powered radio � Flashlight with extra batteries � Cell phone with charger � Books, games, puzzles � Contact list of healthcare members � Picture ID � Car tank full of gas/alternative

transportation

Discuss your emergency plans with your household members and care team.

Patient Assistance Hotlines ARA: 888.880.6867 DaVita: 800.400.8331 DCI: 866.424.1990 Fresenius: 800.626.1297 US Renal Care: 866.671.8772

ESRD Network:______________________________ This material was prepared by the Kidney Community Emergency Response (KCER) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. CMS Contract #: HHSM-500-2016-00007C Publication Number: FL-KCER-7K2T3C-07252018-01.

Emergency Preparedness Checklist and TipsAn emergency can happen at a moment’s notice.

Act now and prepare before disaster strikes!

This checklist will help you get started.

You’re not prepared if you cannot check these items on your plan:

My dialysis facility has the current street address and phone number(s) needed to contact me and/or household member(s) or care partner(s).

I have discussed my emergency plan and my dialysis facility with my household members. Dialysis facility name: ________________________________________Dialysis facility address: ______________________________________Dialysis facility telephone number: ______________________________

I have a back-up plan to get care if my dialysis facility is closed. Alternative dialysis facility: ____________________________________Alternative dialysis facility address: _____________________________Alternative dialysis facility telephone number: _____________________

I have a copy of my current treatment prescription record.

I check the items in my emergency kit every six months to ensure they have not expired and are working properly.

I review and update my emergency list at least every six months. Use this list to help you build your emergency kit:

• Prescription medications andlist of medications

• Insurance and/or Medicare card• Current copy of monthly lab report• First aid kit• Bottled water• Renal diet friendly

non-perishable food• Cash• Spare glasses

• Manual can opener• Warm blanket• Battery-powered radio• Flashlight with extra batteries• Cell phone with charger• Books, games, puzzles• Contact list of healthcare members• Picture ID• Car tank full of gas/alternative

transportation

Patient Assistance HotlinesARA: 888.880.6867 DaVita: 800.400.8331 DCI: 866.424.1990 Fresenius: 800.626.1297 US Renal Care: 866.671.8772

ESRD Network: _________________________

This material was prepared by the Kidney Community Emergency Response (KCER) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. CMS Contract #: HHSM-500-2016-00007C Publication Number: FL-

KCER-7K2T3C-07252018-01.

The End Stage Renal Disease Network of Texas, Inc. Patient Engagement Learning and Action Network

Fact Sheet on Home Hemodialysis In Standard Home Hemodialysis, you and a partner train for a few weeks and learn to do your treatments at home, three Ɵmes a week – the “standard” schedule that is used in most dialysis clinics. At home you can choose to do longer treatments, or – much beƩer – a treatment every other day. More dialysis is beƩer. Standard Home Hemodialysis is also referred to as convenƟonal home hemodi-alysis. Most clinics do require that you have a “helper” and you will need space for your chair, machine, water tanks (some machines) and supplies at your home.

Training: AŌer your access is ready to use, you’ll have a few weeks of training. Your training nurse will teach you and your partner to:

Set Up a Treatment Room Keep treatment logs Take Care of Your Access and put in needles Take your blood pressure Figure out how much fluid to remove Follow your diet and fluid limits Run and care for the dialysis machine Recognize and report any problems Store and order your supplies

A nurse will be on call if you need any help.

Benefits of Standard Home Hemodialysis Dialysis: Flexible – plan your own schedule, keep Quality – dialyze longer to feel beƩer

your job Access – lasts longer when you put your Control – eat, drink and have visitors during own needles in

treatment Longer life – about twice as long as Time – fewer trips to the clinic standard in-center HD

Who is Best Suited for Standard Home Hemodialysis? The most important factor in whether you are suited for standard home hemodialysis is how much you want to do it. As long as you or a partner can pass the training and learn to place your needles, you should be able to succeed.

InformaƟon Courtesy of Home Dialysis Central

Consider Your Dialysis Choices: Choosing the right option for you!

Choosing a treatment option for your kidney failure is a personal decision. It is important that your choice supports your lifestyle and values. The right treatment for you depends on these factors and on your medical condition.

Learn more about your dialysis options to choose the treatment that’s best for YOU!

This tool will help you review the different dialysis options that may work for you and what you may need to consider.

Would you like other resources to help you make this choice?

Please visit the “My Life, My Dialysis Choice” online tool offered by Medical Education Institute, Inc. (MEI) to help you learn more about available dialysis treatment options.

Visit: http://mydialysischoice.org/

You may also want to consider kidney transplantation as an alternative to dialysis. Visit the ESRD NCC website at http://esrdncc.org to learn the facts about transplant and what the process involves.


Home Hemodialysis (HD)

Why it may work for you: • Allows more independence and control of treatment

and life choices.

• Permits more frequent or longer treatments than can be provided with in-center dialysis. This can lead to more waste products being removed and better lab results.

• You don’t have to travel to a center to receive treatment.

• Many patients say they have more energy after treatments compared to how they feel after in-center dialysis.

• Dialysis staff members are available to answer questions on the phone.

• May make it easier to return to work or school.

• Allows you to travel. Supplies can be shipped to you anywhere in the United States, and the machine can go on an airplane.

• If you can learn to drive a car, you can learn to perform treatment at home.

What you may need to consider: • Training is required and more involvement in your

own care is necessary.

• You might need a care partner to help you with the treatments, depending on the procedures in your area, i.e.,state regulations, program guidelines or facility rules. You can speak with your social worker to discuss available options.

• If you have a fistula or graft, you or your care partner will have to put in your needles.

• You’ll need storage space for supplies.

• You may need to upgrade the existing plumbing and/or electrical outlets in your home to meet requirements for the machine.

• You will need to attend monthly clinic visits to review your treatment plan.

• Your monthly utility bills could increase, based on additional water and electric usage; you might want to check with your center regarding any additional expenses.

• Some programs will not allow you to have pets in your home.

Nocturnal Option: • Takes place while you sleep.

• Could limit your sleeping position.

• Uses time you sleep for treatment; freeing your days.

• May allow you to return to work or school full time.

• May have fewer diet restrictions and possible improved labs with the additional hours available for receiving treatment.

◊ Would you like to fit dialysis into your schedule?

Would you prefer to stay home for treatment or go to a dialysis center three times a week?

Do you want the control of delivering your own treatments?

Is travelling important to you?

◊

◊

◊


Why it may work for you: • Allows more independence and control of treatment

and life choices.

• Your own body, not a dialyzer, cleans your blood.

• Needles are not used; your blood does not leaveyour body.

• You don’t have to travel to a center to receivetreatment; could be performed at your location, i.e,home, school, or work.

• Many patients say they have more energy afterthese treatments compared to how they feel afterin-center dialysis.

• Dialysis staff members are available to answerquestions on the phone.

• You decide how to fit your exchanges in to your dayor night schedule.

◊ Would you rather have a treatmentwithout using needles?

Would you like to fit dialysis into yourschedule?

Would it disrupt your life if you weren’table to participate in underwateractivities?

Is travelling important to you?

Do you want the control of doing yourown treatments?

◊

◊

◊

◊

• May make it easier to return to work or school.

• You may have less diet restrictions than within-center dialysis.

• Allows you to travel. Supplies can be shipped to youanywhere in the United States.

What you may need to consider: • You must do it every day from your home.

• Training is required.

• You’ll need storage space for supplies and enoughspace to do the therapy.

• A tube will be inserted into your belly, also knownas your peritoneal space.

• You may have concerns about body image becauseyou will have fluid and a catheter in your belly.

• You may be more likely to get an infection in yourbelly.

• You will need to attend monthly clinic visits toreview your treatment plan.

• You may need to avoid underwater activities.

• Some programs will not allow you to have pets inyour home.

Nocturnal PD: • Most shifts start in the evening hours and go into

the night.

• Treatments take place during hours when you maynormally be sleeping, freeing up daytime hours.

• Requires a machine called a cycler.

• May better allow you to work or go to school on afull-time basis, since your days are free.

• May have fewer diet restrictions with the additionalhours available for receiving treatment.

• Possibly limits your sleeping position.

In-Center Hemodialysis (ICHD)

Why it may work for you: • You have professionals with you at all times.

• Does not require training on how to do treatments.

• Does not require the help of a care partner.

• Does not require storage of supplies.

• May allow you to interact with other patients whoare going through similar experiences.

• Dialysis centers are widely available.

What you may need to consider: • Needles need to be placed for your fistula or graft

at every treatment.

• You may require a rest after each treatment.

• You may need to provide your own transportationto and from the dialysis center.

• The number of treatments and schedule fortreatments are fixed; you may have difficulty pickingyour treatment schedule.

In-Center Nocturnal: • Usually takes place during the evening hours, you

may sleep during treatment.

• May allow you to work or to go to school on afull-time basis, since your days are free.

• May have fewer diet restrictions and possible improved labs with the longer hours of treatment.

• Your position during sleep will be limited and yoursleep may be disrupted in the clinic setting.

• Limited number of dialysis centers with in-centernocturnal programs.

◊ Would it be difficult for you to completethe training required for peritoneal orhome dialysis?

Is it better for you to receive treatment ina center?

Would this be easier for your family andthose who care for you?

Would you like professionals aroundduring your treatments to take care ofyou?

Would you like to be around other peoplegoing through the same thing?

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Distributed in partnership with

End Stage Renal Disease National Coordinating Center website: www.esrdncc.org •email: [email protected] • (813) 865-3535

www.facebook.com/esrd.ncc @esrdncc Prepared by the National Patient and Family Engagement (N-PFE) Learning and Action Network (LAN), under the ESRD NCC. The ESRD NCC gratefully acknowledges HSAG: The Florida ESRD Network and National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) as sources for development of the content used in this resource. For more information visit: www.niddk.nih.gov.

This publication was developed under Contract Number HHSM-500-2013-NW002C, titled “End Stage Renal Disease National Coordinating Center (ESRD NCC)”, sponsored by the Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services, and adapted under contract Number: HHSM-500-2016-00007C. The contents presented do not necessarily reflect CMS policy. Pub #: FL-ESRD NCC-7N12B1-06172016-01

mailto:[email protected]

The End Stage Renal Disease Network of Texas, Inc. Patient Engagement Learning and Action Network

Fact Sheet on Peritoneal Dialysis Peritoneal Dialysis (PD) uses the inner lining of your abdo‐men (the peritoneum) as a dialysis filter. The peritoneum is lined with Ɵny blood vessels. Wastes and extra water in your blood can flow out of these blood vessels, through the peritoneum and into special fluid that you put into your abdomen. Then you drain the fluid, and the wastes, out of your body.

PD Catheter: To do PD, you’ll have to have a soŌ plasƟc tube, called a catheter, placed in your abdomen by a surgeon. You’ll learn how to use the catheter to fill your abdomen with a sterile fluid called a dialysate. Most people use about 2 liters of dialysate for each treatment.

PD Exchanges: AŌer you put the dialysate in your abdomen, it stays there for a few hours. The period between puƫng fresh fluid in and taking used fluid out is called dwell Ɵme. While you go about your day, the fluid will collect all of the wastes and water it can hold. Then you drain out the used fluid and put in clean fluid. This process is called an exchange. There are two types of exchanges: 1. Exchanges by hand – usually 4 each day, and2. Exchanges with a machine while you sleep at night.

Benefits of Peritoneal Dialysis:

Portable – take it with you

Saves Ɵme – fewer trips to clinic

No needles – avoid needle sƟcks

Flexible treatment Ɵmes

Easy – learn it in a week or two

Fewer limits – eat a more normal diet

Who is Best Suited for PD? The most important factor in whether you are suited for PD is how much you want to do it. If you have had many or complex abdominal surgeries, you may not be able to do PD. If you are a large person, it may be hard to get enough dialysis with PD. If you have a hernia, it must be fixed before you start PD. SomeƟmes PD can cause a hernia and if so, there is a way that you can conƟnue your treatments while it is being fixed.

Remember to compare all the advantages and disadvantages for each of the dialysis types so that you can find the treatment that works absolutely best for you!

InformaƟon Courtesy of Home Dialysis Central

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