Patient who is a quad and trached needs training for inhome HD

We are having difficulty finding a HD center willing to train our patient’s wife to perform in home HD due to his open trach. Any thoughts on how we can get this family trained without going to a HD center?

I have found when I get calls or emails like this that dialysis clinics are often unwilling to accept patients with trachs. I have communicated and advocated with DaVita and Fresenius about this issue. DaVita leadership told me they’re certifying some of their clinics to work with trach patients. They and Fresenius and DCI may admit patients to their in-center or home programs on a case-by-case basis based on the patient’s status. Here’s a KidneyViews blog I wrote about this challenge.

A company that offers staff-assisted dialysis in nursing homes has given me a list of the nursing homes where they do dialysis, some of which accept patients with trachs in case the patient/family might consider placement in a nursing home that offers hemodialysis.

Has anyone assessed the patient’s candidacy for peritoneal dialysis? Some patients with trachs have been able to do PD successfully. Training for PD is much faster than training for HD and the patient may be able to do PD while sleeping. Here are a couple of KidneyViews blogs from the Home Dialysis Central about this topic.

Some patients who are quadriplegics and who have trachs are stable and have a decent quality of life. Others are so debilitated that they have poor quality of life. In some cases, conservative management without dialysis may be less burdensome. Here’s another KidneyViews blog on conservative management.

What town do you live in