The last thing the dialysis industry needs, or can even afford, are self-reliant individuals. If such people became the norm, that would destroy not only the agenda and the careers of those in the dialysis industry, but even their flattering image of themselves as saviors of dialysis patients.
Sorry I missed this post for so long. Medical Education Institute that administers Home Dialysis Central started the Life Options Rehabilitation Program in the early 1990s with the goal of providing tools to patients and professionals to help people with kidney disease learn to manage their disease and participate in their care as fully as they can, including maintaining employment or returning to work when possible. This program has discouraged staff from doing things for patients that they can do for themselves, which could foster dependency. Check out www.lifeoptions.org.