OUR DIALYSIS CONSULTANTS HAVE THE EXPERTISE AND CAN HELP YOU ESTABLISH YOUR NURSING HOME DIALYSIS BUSINESS:
The number of geriatric end-stage renal disease (ESRD) patients in the United States is increasing disproportionately to other age groups on dialysis. Thus there will be more dialysis patients that will require the assistance of nursing homes or extended care facilities. Nursing homes may be beneficial for the geriatric patient in terms of social and physical rehabilitation. Many of these facilities, however, may not take care of or may not have the capacity to adequately care for dialysis patients. Such patients have a higher rate of peritonitis when on peritoneal dialysis (PD) and have higher mortality rates on hemodialysis (HD) or PD compared to similar dialysis patients in the community. Cooperation and communication between the dialysis center and the nursing home, given the complex management issues involved in the care of these patients, are essential. One promising approach to the care of elderly dialysis patients is an integration of nursing home and dialysis unit. Let our consultants help you establish dialysis facilities or programs within the nursing home setting.
A FEW THOUGHTS FOR THE NURSING HOME DIALYSIS POPULATION
It has been suggested that Geriatric practitioners address three areas with their elderly nursing home patients in order to determine if the initiation of dialysis is appropriate:
The number of geriatric end-stage renal disease (ESRD) patients in the United States is increasing disproportionately to other age groups on dialysis. Thus there will be more dialysis patients that will require the assistance of nursing homes or extended care facilities. Nursing homes may be beneficial for the geriatric patient in terms of social and physical rehabilitation. Many of these facilities, however, may not take care of or may not have the capacity to adequately care for dialysis patients. Such patients have a higher rate of peritonitis when on peritoneal dialysis (PD) and have higher mortality rates on hemodialysis (HD) or PD compared to similar dialysis patients in the community. Cooperation and communication between the dialysis center and the nursing home, given the complex management issues involved in the care of these patients, are essential. One promising approach to the care of elderly dialysis patients is an integration of nursing home and dialysis unit. Let our consultants help you establish dialysis facilities or programs within the nursing home setting.
A FEW THOUGHTS FOR THE NURSING HOME DIALYSIS POPULATION
It has been suggested that Geriatric practitioners address three areas with their elderly nursing home patients in order to determine if the initiation of dialysis is appropriate:
- Don’t limit the discussion to the glomerular filtration rate (GFR), a measure of renal function. Instead, consider that there may be conditions in which dialysis may be the only way to improve a condition such as refractory hyperkalemia or fluid overload that is unresponsive to diuretics. There may be conditions in which the underlying problem of adult failure to thrive or cognitive impairment will not be reversed or improved despite the use of this technology. Under those circumstances and despite the GFR, dialysis may not be appropriate.
- Appreciate the life expectancy of the resident, both the functional age as well as the chronological age. The life expectancy of an 85-year-old on dialysis is 12 months.
- Determine the resident’s goals. Is symptom management the focus, avoidance of hospitalization or is the extension of life the principle issue for the individual?