According to Johns Hopkins University, more than half of all seniors over the age of 75 suffer from some form of kidney disease. Research also shows that seniors over the age of 60 are much more likely to suffer from kidney disease than any other segment of the population.
If your senior struggles with this condition, the data will come as no surprise. The truth is that kidney function can decline suddenly and rapidly, leaving many family caregivers scrambling for a solution.
Fortunately, dialysis facilities provide effective treatment for those suffering from even the most advanced forms of kidney disease. The real question is how to select the best dialysis clinic for your senior to ensure the best possible quality of care.
While there are many factors to keep in mind, you can start by checking out the Resource Hub provided by Seasons. You’ll find plenty of care options for dialysis facilities in your area on this free, online resource. But what exactly is a dialysis facility, anyway? What are its benefits? What should you consider when choosing the best dialysis clinic for your senior? How do you find dialysis facilities nearby?
Dialysis facilities: increasing quantity and quality of life
What is a dialysis facility?
A dialysis facility is a place where seniors can receive dialysis services. These facilities are often found within hospitals, although many operate independently.
What is dialysis?
Dialysis is also known as renal replacement therapy. This treatment is geared toward those with chronic kidney disease (CKD), and it can improve both the duration and quality of a senior’s life.
Dialysis helps patients get rid of toxins and waste. Normally, this function would be carried out naturally by healthy kidneys, but when seniors struggle with failing or ineffective kidney function, dialysis is one of the few treatment options that can keep them alive and healthy.
Dialysis care helps your senior with a number of bodily functions, including:
- Removal of waste
- Removal of excess salt
- Removal of excess water
- Maintaining a healthy balance of chemicals in the bloodstream
- Balancing potassium levels
- Balancing sodium levels
- Balancing bicarbonate levels
- Control of blood pressure
How does dialysis work?
Several dialysis care methods are available:
- Hemodialysis: This method uses an “artificial kidney.” Practitioners carefully create an entrance in the leg or arm to access the blood vessels. Sometimes, doctors create something called a “fistula” for greater access to the blood vessels. Blood is then transported to the artificial kidney for treatment and waste removal before it returns to the body. Seniors will usually receive in-center hemodialysis at a dialysis clinic. Nocturnal dialysis is another type of hemodialysis, and it occurs at a slower pace during sleep.
- Peritoneal dialysis: There are two types of peritoneal dialysis:
- Continuous ambulatory peritoneal dialysis (CAPD): Seniors or family caregivers can carry out this type of dialysis without machines or help from medical professionals. It involves putting a bag of dialysate into a peritoneal cavity four to five times a day. After four to five hours, the dialysate is drained and discarded in a process known as an “exchange.”
- Automated peritoneal dialysis (APD): This type of dialysis involves a special machine known as a “cycler.” With this approach, exchanges last about an hour and usually occur during sleep.
Why would my senior need dialysis care?
Seniors with kidney disease should consider dialysis. A doctor can run tests and determine whether your senior has developed kidney disease before recommending potential kidney care options. Unfortunately, many seniors wait far too long to begin dialysis.
According to the official guidelines set forth by the National Kidney Foundation, seniors should start dialysis when kidney function drops below 15%. Experts disagree on the best time to start dialysis care. Some say you should begin kidney care before you experience major symptoms, while others claim you should wait until more severe symptoms appear.
Deciding when to start dialysis can be difficult, and your choice depends on your senior’s unique needs and requirements. Doctors may look for symptoms of kidney failure and measure your senior’s glomerular filtration rate (GFR). Generally speaking, symptoms begin to appear when kidneys reach a GFR rate of 5 to 10 mL/min/1.73 m2.
One study found there was no discernible advantage to starting dialysis before major symptoms begin to manifest.
What are some signs my senior should get dialysis?
Some of the earliest signs of kidney problems include:
- Muscle cramps
- Loss of appetite
- Swelling of feet and ankles
- Dry, itchy skin
- Shortness of breath
- Sleep problems
- Excessive urination
- Inadequate urination
When kidney disease becomes more advanced, seniors may experience increasingly severe symptoms, such as:
- High blood pressure
- Irregular heartbeat
- Chest pain
- Extremely low energy
Kidney disease can become fatal because it leads to various complications, including:
- Heart problems due to high potassium levels in the bloodstream
- Heart disease
- Weak bones and an increased risk of fractures
- Lowered immune function
When kidney disease progresses to a certain point, dialysis is often necessary for survival. The only other kidney care option is a kidney transplant. Patients typically live for an additional five to 10 years with dialysis, although some seniors have extended their life expectancy by up to 30 years.
What services do dialysis clinics provide?
Vascular access services
Vascular access centers focus on providing vascular access treatment for patients with end-stage renal disease (ESRD). Staffed by medical professionals who specialize in the field of vascular access, these facilities offer a hospital setting where inpatients can stay for the night.
In-center hemodialysis is also known as “inpatient dialysis,” and it involves seniors traveling to a facility several times a week for a few hours at a time. This approach ensures that seniors stick to a schedule and never miss a cycle. In addition, inpatient dialysis ensures your senior will be supervised and treated by trained and experienced medical professionals at all times. During the dialysis treatment, your senior’s kidney function will be monitored closely.
Medical professionals will prepare your senior for dialysis after arrival at the facility. This involves:
- Sanitization of the access area
- Measuring body weight
- Helping your senior get settled in comfortably
- Checking blood pressure
- Checking temperature
- Checking heart rate
- Checking pulse
- Application of numbing cream if necessary
Light entertainment during the dialysis treatment
Once the needles have been placed in your senior’s access area, they are free to relax during the three-to-four-hour session. Many facilities provide light entertainment, such as a television. Seniors are also free to bring books or laptops to help pass the time, and some enjoy chatting with staff members or family caregivers. Of course, taking a nap is always an option as well.
Dialysis facilities also provide follow-up care after the treatment is complete to ensure your senior’s well-being. After they remove the needle, staff members put a dressing on the access area. Seniors often feel quite tired after each session, and they may also struggle with nausea, dizziness and other minor symptoms. Staff members at dialysis facilities can help your older adult address these concerns with personalized treatment options that maximize comfort.
One of the most important aspects of follow-up care is access area maintenance. With the help of vascular specialists and other medical professionals at dialysis facilities, your senior can avoid clotting and infection of the access area.
Questions about dialysis centers
What types of options are available with dialysis facilities?
Depending on the facility, a wide range of options may be possible, including:
- Home hemodialysis
- In-center hemodialysis
- Peritoneal dialysis
- Nocturnal dialysis
Are dialysis facilities safe?
The safest and most reliable way to receive dialysis treatment is to visit a reputable facility. Although it’s possible to carry out dialysis at home, a facility provides a hospital-like setting with qualified, experienced health care providers who can supervise your senior at all times. Some facilities may also partner with nursing homes to provide on-site dialysis care.
What kind of staff members are employed at dialysis facilities?
- Nephrologists: A nephrologist is a doctor who specializes in kidney care. These are the “team leaders” at dialysis facilities and are responsible for overseeing the care of senior patients.
- Nurse practitioners: Nurse practitioners work with doctors in dialysis facilities to care for patients and are sometimes referred to as advanced practitioners.
- Physician associates: Physician associates also assist doctors with kidney patients at dialysis facilities and are sometimes referred to as advanced practitioners.
- Nephrology nurses: Nephrology nurses are RN or LPN nurses who specialize in patients with kidney problems. Their roles include assessing patients, providing medication and treatment, and overseeing the overall dialysis process. All Medicare-certified facilities are required to have at least one full-time RN who has experience with dialysis.
- Patient care technicians: Also known simply as “PCTs,” patient care technicians are responsible for performing dialysis treatment. This includes the preparation phase, monitoring during treatment, and follow-up care. All PCTs are required to complete a specialized training program and sometimes an additional level of certification.
- Biomedical technicians: Biomedical technicians focus on maintaining dialysis machines and overseeing water quality in dialysis facilities.
- Vascular access surgeons: The vascular access surgeon leads the vascular access care team, and they are responsible for conducting minor surgery to create the access area.
- Radiologists: Radiologists at your dialysis facility may conduct specialized X-rays before access surgery—although the nephrologist may conduct this task themselves if they have sufficient training.
- Access coordinators: The access coordinator is in charge of helping plan treatment, and they follow up after the dialysis treatment. This individual may be a nurse or another health care professional, and quality of care is their primary concern.
- Secretaries: Secretaries meet patients upon arrival at the dialysis center and direct them toward health care professionals and treatment areas.
How to choose a dialysis center
The best way to choose a dialysis facility is to schedule a visit. During your tour of the dialysis clinic, you can ask questions, meet staff and more. You should also bring your senior along so they can provide their own input.
Consider the distance of the facility from your home when making your decision. Depending on the needs of your senior, you might need to drive to the facility on a regular basis. Close health care providers may be much more convenient when you factor in travel time.
What questions should I ask staff members at dialysis facilities?
- What kind of experience do staff members have?
- What kind of qualifications do staff members have?
- What kind of treatments are offered?
- Are your treatment plans covered by my insurance?
Talking about dialysis
Dialysis is a major decision, and you should do your best to involve the entire family in the discussion. Although your senior will likely make the final call, caregivers can help weigh the pros and cons for an informed choice. For instance, it’s generally suggested that those who will seek kidney transplants avoid dialysis if possible.
There are two major concerns when it comes to dialysis care: fear and cost.
How to talk to family members about dialysis
When speaking with your family members about dialysis, a likely subject of discussion will be the cost involved. Dialysis is not cheap, and you may need to explore various grants, loans and government programs in order to lower the financial burden.
While dialysis can be costly, it can extend your senior’s life significantly. If a kidney transplant isn’t a realistic option, dialysis may be the only way to gain more time.
How to approach the topic of dialysis with your senior
A common concern for seniors is the fear and uncertainty associated with dialysis. If your senior doesn’t like needles and has a natural aversion to medical procedures, this could be a hard sell.
Some seniors refuse dialysis and prefer to let nature take its course. While every senior is perfectly within their rights to choose this route, it can come at the cost of time. This care option provides seniors the chance to spend more time with children and grandchildren, get affairs in order, and otherwise take advantage of an extended lifetime.
Words to help a senior consider dialysis
- Dialysis gets easier.
- You can still travel on dialysis.
- Dialysis patients can live normal lives.
- Dialysis can extend your life significantly.
- Dialysis may be discouraged if a senior is eligible for a kidney transplant.
Paying for dialysis
How much does dialysis cost?
A single dialysis treatment can cost more than $500, which equates to annual costs of well over $70,000. The exact cost of your senior’s dialysis treatments depends on how many sessions they need per week and the severity of their kidney disease.
Can I get help paying for dialysis?
You can ease the costs of dialysis with assistance from a number of different sources. Medicare is the most obvious choice, and coverage lowers the cost of each session to as low as $100. Those covered under Medicare have been eligible for a range of dialysis-related benefits since 1972, including:
- Inpatient dialysis
- Outpatient dialysis
- Home hemodialysis training
- Dialysis equipment and supplies
- Prescriptions related to dialysis
Medicare Part A and Part B will cover most of these costs, but you will likely need to pay about 20% yourself.
In addition, there are a range of other sources to consider for dialysis funding:
- Social Security Disability Insurance: SSDI is a form of Social Security that can provide more than $3,000 per month for dialysis or anything else your senior might need.
- Supplemental Security Income: Based on income and other factors, your senior might qualify for SSI. This form of social security provides additional funding each month.
- American Kidney Fund: This national nonprofit organization provides financial assistance to seniors in need of dialysis treatment. The American Kidney Fund offers a range of grants and programs, so contact them directly for more information.
- Private health insurance: You can also turn to private health insurance for additional funding, and many private plans offer comprehensive dialysis benefits.
- TRICARE: TRICARE is available to retired military veterans. This source of funding provides dialysis and hemodialysis coverage for end-stage renal disease.
- Veteran’s Benefits: The VA also covers dialysis for enrolled veterans.
- State medical assistance: Individual states may also offer some form of funding assistance for dialysis, so check with your local government for more information.
- Local charities and nonprofits: Aside from the American Kidney Fund, there are many other charities and nonprofits around the nation that may offer assistance. Your local area may be home to one of these nonprofits.
How can I find dialysis facilities near me?
Seasons makes it easy to find excellent dialysis facilities nearby. Check out our Resource Hub to start searching for facilities in your area. This free online resource provides you with plenty of information to get started, and you can start creating a short list of potential facilities right away. Find a dialysis facility near you today and improve the quality and quantity of your senior’s life.