Jackson Brown-John loves living in Horsefly, a rural community located about an hour east of Williams Lake. He was born there, works there, and loves spending time there with his partner, Dianna MacQueen, amid the abundance of hills, forests, and clear lake watersJackson, 59, is also a kidney patient. His kidneys have failed and he had been travelling three times a week to Williams Lake for life-sustaining dialysis to replace his kidneys’ function. Now, though, Jackson can access care right in his own bedroom, thanks to Interior Health’s home hemodialysis program.
“It has made it a lot nicer, the fact that I don’t have to travel anymore,” Jackson says. “I just do it in bed, where I’m comfortable, watching TV, or falling asleep.”
Kidneys play an important role in the human body; they produce hormones, absorb minerals, filter blood and produce urine. Those with kidney dysfunction must undergo regular treatment to cleanse their body of toxins that would otherwise be fatal. This is usually done through conventional hemodialysis in a hospital or community dialysis unit; or through peritoneal dialysis, in which patients can have their treatments at home by instilling special fluids into their abdomen to remove toxins from the kidneys. The right treatment for the patient depends on the individual’s needs and the stability of his or her illness.
But not every patient lives near a kidney dialysis unit or can tolerate peritoneal dialysis. In addition, for those people that have to drive, the cost of time and travel can also be a barrier to their care. However, for those whose health is stable and who are willing to take a greater role in their own care, there is the additional option that Jackson chose: hemodialysis in his own home. It’s a great option for patients, who appreciate the flexibility home hemodialysis gives them to schedule their own treatment – whether it’s at night while they sleep, or every other day, or during short daily treatments.
“The treatment time varies, depending on the patient’s needs and lifestyle choices,” says Corinne Gable, one of four regional home hemodialysis nurses in IH. “Usually, the more dialysis time people do, the better they feel. It’s also easier on the body to take off excess fluids over a greater timeframe.”
Recognizing that Interior Health covers many remote areas, the IH Renal Program, with the support of the BC Provincial Renal Agency, launched a new regional project in May 2015 focused on providing home hemodialysis training to willing patients who reside in rural communities. All home hemodialysis patients are provided comprehensive training, follow-up care and ongoing support, but normally this training is performed in a major renal centre. With the IH Renal initiative, this training was instead provided directly in a patient’s community and home, as opposed to a major centre – a first for B.C.
It was ideal for Jackson, whose journey to kidney dysfunction was actually no journey at all – it was a roadblock, the result of a rare autoimmune disease that caused his kidneys to abruptly fail in August 2014. He tried conventional hemodialysis, which worked well but was restrictive, given that he needed to travel so far to receive his four-hour treatment – two hours round trip each time. He tried peritoneal dialysis, but his body didn’t tolerate it well.
Then Jackson was recommended for home hemodialysis. He and Dianna spent six weeks training in Williams Lake and then in their home to perform the treatment, including instruction on how to weigh Jackson and take his blood pressure; how much fluid should be removed on each run; and, how to hook up, take down and disinfect the hemodialysis machine that is permanently located in their home. The couple was also taught how to handle unexpected situations, which would otherwise be addressed by nurses if Jackson was dialyzing in a health-care facility.
“There is the freedom and flexibility of being in your own home and your own bed. The whole experience has been wonderful,” says Dianna.
Jackson says it took time to learn and understand it.
“But it seems quite simple now that I’ve done it,” says Jackson, who is now doing his treatments four times a week, overnight while he sleeps. “I am overwhelmed by all the help. There are probably six people we could call – the technicians who run the machines, the clinic in Kamloops or Williams Lake. They bend over backwards to help you.”
These kinds of sentiments are music to Lauren Kembel’s ears. Today, 22 home hemodialysis patients are supported across the Interior Health region. Lauren, who oversees the home hemodialysis program, is thrilled to see people take ownership of their health again.
“It’s giving someone their independence back,” she says.
The provincial home hemodialysis program was established in 2004 by the BC Renal Agency in collaboration with health authority renal programs. Funding is provided by BC Renal for all aspects of care, including care teams, home hemodialysis machines, supplies and initial renovations to the home for plumbing and electricity if needed. Approximately 160 patients across the province manage their home hemodialysis treatments independently.