ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Fri Oct 03, 2003 12:31 pm Post subject: solutions
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in my oponion the solution is self care in the clinic. some will be able to do home care but with our changing family pattern the majority will not have the proper home setting to do home treatment. with the health care costs increasing 15 per per year a patient load increasing at a rate of 7 percent mutch greater if we start getting adaquate treatment, a decrease in the tax paying base, the patient are going to have to start bearing some of the load. come on give me some feed back as i see this is our major problem.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sat Oct 04, 2003 12:05 am Post subject: Self Care
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Ridgerunner I think we are putting the cart before the horse. You can't initiate self care or home hemo until the centers have the programs available. What's the point in debating what isn't available. I can see giving knowledge but that's about all we can do until the programs are available.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Sat Oct 04, 2003 4:48 am Post subject: Not that...
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Not that I really disagree with Ridgerunner but Marty is correct in that units need to offer these modalities in order to get an even better feel for who can and cannot participate in Home hemo. These to articles, Wall St Journal and IKidney are fantastic in that they lay out the difficulties especially financial aspects. 2008 is a long time to wait for CMS to decide whether longer and home dialysis is beneficial.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sun Oct 05, 2003 1:36 am Post subject: Waiting until 2008
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I personally think the wait is ridiculous. There are enough programs now that have been operating for over 5 years that the information is available. But if we say we need a study that prolongs the truth coming forward and delays payment. Doesn't appear that our government has much compassion for the patients who want to have a life today not 5 years from now if they all can hang on that long.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Sun Oct 05, 2003 2:56 am Post subject: solutions
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i think every one is missing my point. the adverage patient feels that they should have everything done for them. they think that is there right. until they start accepting the fact that that ESRD is their problem and start doing something.things will stay the same.
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SHIRTS
Joined: 13 Jan 2003
Posts: 39
Posted: Sun Oct 05, 2003 4:39 am Post subject: SELF HELP
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RUNNER YOU R 100% RIGHT ON<
>IN MY CLINIC SOME ABLE BODIED PTS WILL NOT EVEN OPEN THEIR HARD CANDY WITHOUT HELP<
>
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Not
Joined: 24 Jun 2003
Posts: 2
Posted: Sun Oct 05, 2003 8:53 am Post subject: many able bodied patients
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Shirtz - they come to dialysis with poor habits and then they are taken over by poor dialysis. They become physically and mentally off and by that time they can barely take the wraping off the candy. The next step is premature death! <
><
>You don't make irresponsible-type patients responsible by ususing cardboard paper Daves or otherwise treaing them like children. They need serious spiritula,mental and emotional rehabilitation and even then many will not respond because they choose not to. There is only a small grouping of patients who are willing to change. <
><
>Now you've got two groups of patients who are able to take responsibilty for themselves, the whole and educated type and the type who is willing to change. Nevertheless, that does not mean that either are able to do total selfcare. The disease can render even willing patients weak, and there is no way to make a blanket rule of what patients can do as far as self-care. <
><
>Individual patients may be able to care for themsleves to different degrees one tx and not the next. There is nothing wrong with being cared for when care is necessary. What do you think the medicals get paid for? Can't legislate patient self-care. But patients who are whole will want to do what they can when they can.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Sun Oct 05, 2003 11:01 am Post subject: self care
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excuses yes the system needs to change but the patients too.
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YOur
Joined: 05 Oct 2003
Posts: 1
Posted: Sun Oct 05, 2003 11:39 am Post subject: too rigid
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ridgerunner. IMHO You don't know what it's like to be in another person's mind and body. Quit judging!
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Oct 06, 2003 1:37 am Post subject: No offense
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but not all people are capable of selfcare, and besides the nurses aren't about to take on that kind of liability, after all the techs are already working under their license. I worked in healthcare long enough to know that a nurse's license is very valuable to him/her, and so if they tell me I'm not allowed to touch the machine, I'm not going to!<
>Ridgerunner, I'm curious about your opinion that dialysis pts. should be taking care of themselves. I just have to wonder if your opinion applies to other settings! Is it just dialysis pts. you think should care for themselves, or do you also think hospital pts. shouldn't expect to be taken care of. I'm independent, but gee whiz if providers are being payed thousands of dollars just what is that money supposed to be for? If they agreed to let us do selfcare in leu of charging less that would be one thing, but I don't see that happening. If one is going to care for oneself, it is because there are more benefits to doing home care, instead of incenter.<
>I'm independent and want to care for myself, and wish that the home hemo were available to me. Rogosin is inner city NYC, out of my reach but am contacting them to see if they would consider starting another unit in NJ. I don't mind that they are "picky" about who they let into their program; I think I could stand up to the scrutiny. I did read they come out and go over your home, and don't really care for pet hair; wonder where and how I will hide my furries, especially the Golden hmmmmm! Lin.
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Home boy
Joined: 06 Oct 2003
Posts: 2
Posted: Mon Oct 06, 2003 3:48 am Post subject: pets in house
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lin, your golden should be fine. i used to dialyze at home with a cocker spaniel at my feet with a nurse, tech witchever the service would send to my home. and a chow chow would greet the rn, or tech at the door. never had an infection although the spaniel would jump in bed and curl up at my feet for three and a half hours. i have since moved out of the service zone and cannot locate a helper for home hemo and must go to clinic in the neighborhood.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Oct 06, 2003 4:09 am Post subject: Thankyou!
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In the Wall Street Journal article it was
ought up that Rogosin frowns upon shedders in the home because it can affect the machine; not sure how, but......<
>Anyhow, thanks. I would have a hard time hiding my furries, and for that matter their fur. It's hard to blow up an Electrolux but I've done it. Lin.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Mon Oct 06, 2003 4:59 am Post subject: Lin...
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...don't be to worried about the cats. Lois and I had plenty and all FMC really required was that they not be around during TX. Especially during put on and take off. We even cheated by having them around during the TX to keep her company and the nurse knew all about it. You just don't want hairs getting into the lines and what have you. Here is the other article on home hemo with Dr. Blagg.
www.ikidney.com/iKidney/I...ysis11.htm <
>Might have to copy and paste.<
>And yes Marty the wait is ridiculous. I believe the evidence is there already.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Mon Oct 06, 2003 10:57 am Post subject: self care
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i guess i am of a different age pre health insurance when it was not unusally for a child to be born at home, when a working man could pay for his or his families health care. when a family took care of his own. there was no such thing malpractice insurance. treatment was more kind and personal. as far as being liable for something that a patient does for them selves is so much bunk. if a patient takes too much insulin it is their fault. if a patient does not read directions it is their problem. yes this applies to all problems in the health care field .
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Mon Oct 06, 2003 12:33 pm Post subject: I see this just the opposite
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I don't have a problem at all with patients making the decision that home care or self care is not for them. There are many reasons a patient couldn't do home dialysis and it's up to them to make that decision for themself. I don't mind giving someone who is riding the fence on the decision some encouragement but the decision or judgement on who should and who shouldn't isn't ours.<
>The problem we have right now isn't going to be solved by trying to make more patients independent the problem we really have is that independent patients "aren't allowed" to be independent.
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Ewww
Joined: 06 Oct 2003
Posts: 1
Posted: Mon Oct 06, 2003 6:30 pm Post subject: Dog Hair!
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No offense, but isn't dog hair in the house pretty unsanitary? I know you love your furies, but aren't you risking your health with all that hair and dander? <
><
>I had pets when I was a kid and back then they slept in my bed with me. I was allergic to them, but i loved them so much I didn't care. <
><
>I feel so bad now realizing how I tore up my Mom's house as I'd insist I had to have my pets inside. She would plead with me to get em out, but I didn't listen. She finally gave up. But now as an adult, I can't stand the idea of pets in the house.
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Home boy
Joined: 06 Oct 2003
Posts: 2
Posted: Mon Oct 06, 2003 9:28 pm Post subject: to ewww
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you must have a job that takes you out of the house, i don't so i have plenty of time to clean and vacuum and change bed linens. sometimes i prefer the dogs over a smart-mouthed teenagers i encounter from time to time.<
>my judgement call only.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Oct 15, 2003 8:46 am Post subject: No big surprise to me!
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Pet fur and dander can be annoying, but unsanitary? It's no more unsanitary than other dirt in your house. My dogs are routinely bathed and groomed, and aren't left loose to roam. They make regular trips to the vets. for checkups and vaccinations. I even
ush their teeth!<
>A recent study showed that children who had pets in the home from an early age on were LESS likely to have allergies than those who didn't, much to everyone's surprise. I worked in healthcare a very long time and most of that was in home care, and so I know that people can live in filth but go to the hospital and come home with an infection. I guess we become immune to what is in our surroundings. As to the fur in my home, and sometimes on my clothes, that's what they make vacuums and duct tape for lol Lin.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Tue Oct 21, 2003 5:18 am Post subject: Cats
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Another reason that FMC did not want cats around was that they tend to be drawn to small moving objects such as the blood lines on the dialysis machine. They didn't want them playing with the tubes and of course pulling them out. Reasonable I think.
