If your kidneys have failed, you will need dialysis treatment. The majority of dialysis costs, whether for home or in-center treatment, are paid through medical insurance, either your own insurance or the government-sponsored Medicare program.
In 1972, the Social Security Act was changed to extend Medicare benefits to people of any age with end stage renal disease as long as they meet certain requirements based on work credits. Find out about the requirements for Medicare coverage.
In addition, the improved outcomes that generally accompany home dialysis often allow dialysis patients to return to work or continue working, making it possible for many patients to take advantage of their companies' medical insurance.
If you are able to continue working, you may want to in order to be covered by your company's insurance plan. If you have any questions about whether your company's plan covers home dialysis, talk to your Human Resources department. Someone there will be able to help you find answers to your questions.
Another option for paying for home dialysis is to buy your own medical insurance. The dialysis costs covered by a personal insurance plan vary, depending on the plan you purchase. The only problem with personal insurance plans is that some do not cover treatment for health conditions that you have received treatment for before purchasing the plan. For this reason, you should ask about any restrictions on pre-existing conditions.
A member of your health care team, your social worker, can talk to you more about insurance and help you find the plan or combination of plans that works best for you.
If you and your doctor have determined that home dialysis is right for you, you'll work with a home dialysis provider to participate in a comprehensive training program that is tailored to your specific medical and learning needs. A quality training program will provide the education, tools and support needed to stay healthy and safe while enjoying the many benefits home dialysis can offer.
Every patient and his or her treatment are unique and training needs vary, so home dialysis providers personalize training programs to help you understand how to perform your individual treatments. During your training, you will learn all the skills and procedures needed to regularly perform your treatments independently. The wide range of topics will include how to: use your equipment, create a hygienic environment, manage supplies, handle needles and keep an organized log of your treatments, among other essential tasks. The length of training programs varies, but most people can usually learn how to safely perform their own peritoneal dialysis within a couple of weeks and home hemodialysis treatments within three to five weeks.
During training, you will be encouraged to ask any and all questions you may have. No question is too dumb, and you can never ask too many questions. DaVita's home training nurses are great with people and truly care about each patient that they train. They spend plenty of time with each patient to make sure that everyone is given the time and attention needed to learn the home dialysis process through and through. The newest home dialysis machines on the market are also extremely user-friendly, making it even easier to learn to do home dialysis.
After the training, some patients are so confident about their skills that they say they know just as much as the nurses and could teach someone else to do home dialysis themselves.
New technological advances have made more reliable and user-friendly home dialysis machines and water treatment equipment available for home dialysis patients. This new generation of machines is easier to set up, clean and disinfect while offering increased flexibility and a much more comfortable experience for patients. The newest hom dialysis machines are designed to take up less space and require fewer supplies, which mean less required storage space.
The NxStage System One machine for home hemodialysis weighs 75 pounds and is 15 x 15 x 18 inches. The water purification system used with the NxStage machine is the PureFlow system. The PureFlow system is approximately the size of a small refrigerator. The NxStage machine sits on top of the PureFlow system. If you need to take your NxStage machine on a trip, you can simply lift it off of the PureFlow system and take it with you. The PureFlow system is not built to travel so you will simply need to bring bags of solution with you on your trips to use with the NxStage machine.
View an animated presentation of how the NxStage System One and PureFlow system work on the NxStage website.
Peritoneal dialysis cyclers for automated peritoneal dialysis have also been designed to take up less space. In fact, Baxter's HOMECHOICE and HOMECHOICE PRO system is approximately the size of a VCR and easily fits on a nightstand. View a photo of the system on Baxter's website.
These new, smaller home dialysis machines make it easy for people who live in small homes or apartments to do home dialysis.
When you do home dialysis, you're not alone. You have an entire medical team focused on your care. These health care professionals will educate you about the different at-home treatments so that with your doctor you can determine which form of home dialysis is right for you. They will also be there to train you, make changes to your dialysis treatment when necessary, monitor your health to help you achieve your best possible results and support you every step of the way.
Your home dialysis health care team is made up of your nephrologist, your peritoneal dialysis (PD) or home hemodialysis (HHD) nurse, your home-training nurse, your renal dietitian, your renal social worker, your care partner and your support system.
Each of these professionals specialize in a different area of your care so that you have a comprehensive team for anything you might need. If you need help understanding your health insurance, your renal social worker will be there to answer all your questions and explain things to you. If you need assistance getting your lab values where they need to be, your renal dietitian can work with you to create a diet that keeps you healthy.
You will likely come to know your health care team personally and see them as friends who genuinely care about you.
Patients learn more
If you're like most doctors, you may think that offering home hemodialysis as an option to your patients means you could potentially lose control of your patients and put their care in someone else's hands. However, this is not true.
Home dialysis patients are not required to change nephrologists. DaVita values partnerships with each patient's personal physician. In fact, DaVita manages every patient's care as a team effort with the physician.
Your patients will have monthly in-center visits with you, their nurses, their renal dietitians and their social workers to make sure everything is going well. During these monthly check-ups, you will have a chance to modify your patients' dialysis treatments if needed, prescribe diet regulations and medication and manage their ongoing medical care. If you would like to see your patients more than once a month, you can simply schedule additional appointments with them.
'The risk of patient loss is greater for physicians who choose against offering home hemodialysis as an option for their patients,' Dr. Michael Aragon, a nephrologist, said.
Most patients on home dialysis report feeling better than they did when they were on in-center dialysis. Among their reported results are more energy, increased appetite, lower blood pressure, reductions in medication(s), better hemoglobin values and the ability to continue working.
They also experience all the convenience, comfort and freedom that comes with dialyzing at home.
'I have successfully dialyzed patients at home that I previously thought were 'too sick.' With the right support system, my 'too sick' patients did great,' Dr. Joel Glickman, a nephrologist, said.
Busy nephrologists often see home dialysis as something that won't fit into their schedules. This is a common misconception.
'My staff was pleased with how well these patients integrated into our PD program, allowing us to provide more options to patients,' Dr. Robert Provenzano, a nephrologist, said.
DaVita's home dialysis program provides full services for home patients, including training and monthly care team assessments. Physicians will see their home hemo and/or PD patients on a monthly basis and work seamlessly with the care team on each patient's progress. In addition, they will receive monthly patient and clinical outcome reports. They will also receive quarterly DaVita Quality Index ('DQI') reports to help them follow their patients' progress and to assess and compare outcomes.
Paper reports are supplemented by the Doctors Using Clinical Information ('DUCK') custom clinical on-line information system. DaVita at Home is committed to supporting physicians, and we respect their busy schedules.
DaVita presonalizes training programs to help patients understand how to perform individual treatments, making it easy for your patients to learn to dialyze at home. During training, your patient will learn all the skills and procedures needed to regularly perform treatments independently at home. Plus, DaVita representatives are around 24/7 for support.
'Many more patients can learn to dialyze than we give them credit for,' Dr. Stephen Fadem, a nephrologist, said. 'The training process was easier than we expected.'
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