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MGH launches new Home Peritoneal Dialysis Service to facilitate treatment for local renal patients at home
By Alyssa Bravo
Michael Garron Hospital’s (MGH) new Home Peritoneal Dialysis (PD) Service is expected to push the boundaries for renal patients in the East Toronto community.
Home PD allows patients to receive dialysis treatment in the comfort of their own homes.
Patients specifically receive peritoneal dialysis, which uses blood vessels in the patient’s abdomen to naturally filter waste from their blood.
The first patient home visit took place as part of this service on June 23.
With Home PD, patients are equipped with the proper tools and knowledge to receive peritoneal dialysis at home overnight as they are sleeping.
At-home treatment offers freedom and independence
Dr. Miten Dhruve, Division Director of Nephrology at MGH, compares the Home PD Service to other renal care options MGH offers, including hemodialysis.
“Hemodialysis requires a patient to be on-site three days a week. It can be a burden on patients and affect their quality of life,” he says.
“Home peritoneal dialysis gives patients more independence and freedom, such as allowing them to work and carry on everyday tasks.”
The criteria for hemodialysis and peritoneal dialysis differ and which treatment is most appropriate for the patient depends on their needs.
Both forms of dialysis help improve the quality of life for a patient.
However, because home peritoneal dialysis is managed by the patient, Dr. Dhruve highlights the importance of support from the patient’s care team in the Home PD Service.
Service supports holistic needs of patients
Jane Scott Baier is a social worker on the Home PD team at MGH.
As social workers focus on the emotional, physical and social implications of an illness, Jane aims to address barriers or challenges that a patient and their caregiver may face during dialysis treatments.
“Every patient is different and we need to listen to what the patient identifies as important to them and then help them gain access to these supports,” she says.
“We can also help identify supports that are needed through ongoing assessments by all team members and through patient education.
“It’s important to make sure the patient agrees with the recommended supports and is given an opportunity to understand why they are recommended,” Jane adds.
Team equips patients with tools for success
Jessica Truong, Registered Nurse (RN) at MGH, also works closely with patients to prepare them for the Home PD process and maintaining the service at home.
This includes everything from post-PD catheter insertion care, exit site care, the management of non-infectious complications and peritonitis, facilitating interdisciplinary supports for the patient and, most importantly, patient education on how to successfully perform peritoneal dialysis at home.
Nurses on the Home PD team train patients and their family members at MGH so they can confidently perform the treatment at home.
After “graduating” from the training sessions, the patient starts the Home PD Service independently with the support of family or, if needed, at-home care nursing.
The patient's primary Home PD nurse provides support, referrals and customized follow-ups for the patient's ongoing needs and at every milestone of their treatment.
The Home PD team also regularly connects with patients to review their treatments and lab work and to discuss any concerns they may have.
Patients most crucial members of Home PD team
Jessica is passionate about and has specialized in peritoneal dialysis for nine years.
She finds fulfillment in being a part of the Home PD team because she plays an essential role in facilitating and focusing on the treatment of patients in the comfort of their own homes.
“I’m able to be a primary source of support for them in this transition from illness to treatment and encourage self-empowerment in the process,” she says.
“I think that there is something so physically, mentally and emotionally therapeutic about being home that really brings a lot to the concept of holistic healthcare. Home PD is one of the modalities that really embraces this.”
Like many other healthcare services, the Home PD Service requires a collaborative working team in order to prioritize and achieve exceptional patient care.
“The significance of working on a team like Home PD is being able to address all of the needs of the patient,” Jane says.
“It's a holistic approach that focuses on the individual and it's a multidisciplinary approach focused on the same objective, which is ‘How can we help and support this individual?’”
Jessica says patients are the most crucial members of the Home PD team.
“The success of their treatment is so heavily influenced by their motivation and their participation,” she says.
MGH’s Renal Program has more than 500 patients and sees more than 20,000 outpatient visits every year.
The Home PD Service expects to see about 24 patients within the first year of its launch.