Hi PatientX, and welcome.
Interesting! This person's perspective reflects her experience--but it's important to note that it is the experience of someone who has taken on 100% of the home HD tasks. And, for 6 days a week of short daily HD treatments, where the tasks-to-treatments ratio, if you will, is quite high.
Let's parse that out a bit.
Some people do home HD by themselves, with no partner. So, the dialyzor does 100% of the work. In this case, the partner is doing 100%. So, there is a continuum of effort from 0 to 100% for the partner or dialyzor. Any given dialyzor-partner pair can work out (and it's best if they do this up front) a deal that falls anywhere along this continuum. Our perspective here is that it's best for the dialyzor to do as much as possible. It's NOT optimal to turn a partner into a patient care technician while sitting on one's behind and doing nothing. That said, the capabilities of dialyzors vary. Her husband had diabetes. Perhaps he also has neuropathy in his hands and problems with his vision. These would render him unable to help much. (I still think that not working outside the home due to home dialysis helper tasks is a bit much, however).
So, the treatment-to-task ratio. Let's say there is 45 minutes of set-up and clean-up for each treatment. If a treatment is only 3 hours long, this means an extra 25% of time is added on. If treatments were done at night during sleep, for 8 hours, those 45 minutes of set-up and clean-up would add about 10%. This would seem to be less effort. More importantly for this woman, it would take much less time out of her day to set her husband up at night and have him dialyze while he sleeps. She could have her days free to work.
We have an article that you might want to read on the topic of becoming a care partner. You can read it here. http://www.homedialysis.org/resources/tom/201005/.