Medicare does not cover the cost of a helper for dialysis. Other types of insurance that offer private duty nursing may cover the cost of a helper for those patients who have no one to help them and don't have the funds to pay privately.
Many patients who do dialysis at home have family members or friends who help with dialysis after they and the patient have been trained. Although most dialysis clinics require patients to have a helper for home hemodialysis, some do not if the patient can prove after completing training that he/she is competent to perform the entire treatment independently, recognizes and will report symptoms/problems that may occur, and has a way to summon help quickly if needed.
There are other options for treatment besides in-center dialysis. Most patients who are trained to do either of the types of peritoneal dialysis (manual or with a machine) can do it independently without a helper.
Dialysis clinics must be certified by Medicare to provide home training and support. Some clinics are not certified to provide home training and support. The dialysis clinic should make sure that your sister is aware of all options for treatment and that she knows where she can get other treatments not provided by her clinic. From the home page of this website, you can find information about options for treatment, what clinics are certified to provide different types of home dialysis in her area, and more. You can also read about options for treatment on Kidney School (www.kidneyschool.org).