Approximately 20 million Americans today suffer from some kind of kidney insufficiency that requires kidney disease care. Kidney diseases that can become chronic include kidney stones, urinary tract infections, or even chronic renal failure that could result in death.
Patients who need extended care and rehabilitation after an acute renal episode requiring hospitalization can receive excellent, cost-effective care in community based nursing facilities – including dialysis if necessary.
How are patients given kidney disease care including dialysis in community based skilled nursing facilities?
- As permanent residents
Many skilled nursing facilities now offer inpatient dialysis sessions on the premises. With this, patients are treated as home dialysis patients, meaning that they don't have to be provided care outside of the facility and can instead do it "at home."
This has several advantages:
- Patients don't have to be transported outside of the facility
- Scheduling dialysis sessions is easier
Incorporating dialysis sessions into daily activities makes dialysis sessions easier because patients can simply arrive at the dialysis unit, have sessions, and return to normal activities
- In general, patient/nurse ratio is greater than with typical dialysis facilities
- Continuity of care is easier to provide
The patient and the dialysis and nursing home staff have a close working relationship and continual communication to make sure needs are met
- In postacute recovery
Also called subacute care, postacute recovery care is a comprehensive inpatient program designed for individuals who have had critical illness prior to kidney disease diagnosis or who have needed to be hospitalized as the disease has progressed or because of an exacerbation. While in the skilled nursing facility, patients recover strength and health until they're well enough to go home.
- For newly diagnosed patients
Patients who have been diagnosed with kidney disease may first have a critical kidney or renal failure episode that requires hospital care. Once they're stable enough to leave the hospital but not well enough to go home, they may come to a skilled nursing facility to recover physical strength, to continue to receive kidney disease care, and to learn how to manage their disease.
- For patients who are managing their disease
Renal patients who have already been diagnosed with kidney disease may also find themselves hospitalized on a regular basis just as a matter of course as the disease progresses. As with newly diagnosed patients, these patients must also undergo significant therapy to regain endurance and strength after a hospital stay. Once they're stable, they can be discharged from the hospital and transferred to a skilled nursing facility to postacute recovery care.
Patients and their families also learn how to do their own kidney disease care. With this, physicians and other members of the medical team develop a course of treatment with patients and their families as full participants. While in the facility, patients and their families learn how to manage the disease at home by focusing on:
- Diet, including any necessary dietary changes that need to be done as a result of the kidney disease
- Medications: How and when they should be taken
- Outpatient or in-home dialysis if needed
- Psychological counseling, if needed for depression, anxiety, and other emotional or mental difficulties related to renal disease, including medications' mood side effects
- Physical therapy and/or occupational therapy to rebuild strength after illness to learn self-care skills as necessary related to kidney care