Yes we need more info. How old is your mother? What “behaviors” does she exhibit? Physical threats? Is she of sound mind?
This is serious. If she has been discharged from a dialysis unit owned by one of the big two companies, that will preclude/include the entire company of dialysis centers that own that unit . There are only one or two major out patient dialysis providers here in the US.
If the behaviors are that she pulls out her needles (losing a lot of her own blood) or possibly spraying blood on staff or other patients, that’s not good.
I was a dialysis administrator. There is a process that must be followed. Those companies have a lot of attorneys on staff familiar with Medicare rules know how to navigate them. Those attorneys provide guidance to the dialysis center management so if she is discharged b/o behavior, the attorneys assure the DC process is implemented & the reasons are iron clad non negotiable and legal. The company will not take a chance to jeopardize the safety of staff or other patients. Every step is this is done via certified mail with delivery confirmation. The company doesn’t play.
First we asked the patient’s family to provide a sitter or family member to sit with the patient the entire time they are receiving treatment to make sure they don’t pull out the needles or get agitated..
It is not the responsibility of the dialysis center to provide the sitter.
At times the patient is given a letter of impending discharge from that clinic with 30 days notice and is given a list of other local clinics for the family to call and arrange a spot and transfer there. Her original center forwards medical records. After those 30 days, however, the patient will not be accepted back in to her original center as it is felt that with the info provided to the family/patient 30 days notice is legal and acceptable and NOT considered abandonment by the dialysis company as the person was given due notice.
However if the family has not followed through providing supervision re sitter request and/or the patient is a physical threat to anyone in that center, discharge can be immediate.
In that case the dialysis patient will need to go to the hospital each time they feel fluid or electrolyte overload to get a treatment and then sent home until next time the need arises. The patient is told to watch their fluid intake and follow the ESRD diet as they will not have a scheduled treatment anywhere and will have to take their own precautions. The onus is on the patient. While the hospital won’t refuse to treat them acutely that person may have to go thru admission paperwork each time they go to the hospital for acute treatment so they have to wait longer like the rest of us and can often die while waiting if the person has not followed their ESRD fluid and diet restrictions.
Its a terrible situation. A huge mess.
Don’t know if the OP will return with more details but if it’s behavioral try to get your mother admitted to a psych ward for medication titration to get those behaviors controlled (or try to).
If dialysis has become unbearable to mom maybe it is time to stop treatment and let her go. For most It’s a miserable existence on dialysis. It could be for her as well. Have a frank discussion with mom if she is able to do so and find out what her feelings are about continuing hemodialysis. She cannot be forced to receive dialysis or restrained during it.
If she is tired of it and wants to stop, call in Hospice who will provide lots of support during end of life.
We are assuming that she has a form of Dementia. As said, its hard for a Dementia patient to understand what is going on. They can't be restrained. From what I understand it takes hours to go thru the process. The nurses probably can't "babysit". Your other post says something about finding another facility. Since we are from all over the US and other countries, we can't help you find a facility. We r Caregivers sharing our experiences. As said, you need to talk options with her doctor. One option maybe to go on Hospice and allow nature to takes its course. I have a friend who went thru 600 treatments only to choose not to do it anymore. He passed.
I am not certain what you mean. Does she live in a dailysis unit? Or has the dialysis company refused to treat her? Are they unable to handle her, keep her quiet during treatment, or whatever? Because if no one will give her dialysis at this point it is a problem for the doctor. I would love more information here. Is your Mom suffering from dementia? Does it manifest with violent acting out? Have her doctors evaluated her for a need for medication (always problematic for someone on dialysis because of the problem with the body functioning being up, down and all over the place). Is your mother of an age. Does she want to continue dialysis. I am 78. I would not go on dialysis at this point, and were I on it I would stop it and go on hospice with "the good drugs". All of this can go on only so long when the major body systems begin to shut down one at a time. This is the time for the person who is health care proxy or POA to meet with the doctors and decide if palliative care may not be the way forward. You cannot do any of this on your own.
This is serious. If she has been discharged from a dialysis unit owned by one of the big two companies, that will preclude/include the entire company of dialysis centers that own that unit . There are only one or two major out patient dialysis providers here in the US.
If the behaviors are that she pulls out her needles (losing a lot of her own blood) or possibly spraying blood on staff or other patients, that’s not good.
I was a dialysis administrator. There is a process that must be followed. Those companies have a lot of attorneys on staff familiar with Medicare rules know how to navigate them. Those attorneys provide guidance to the dialysis center management so if she is discharged b/o behavior, the attorneys assure the DC process is implemented & the reasons are iron clad non negotiable and legal. The company will not take a chance to jeopardize the safety of staff or other patients. Every step is this is done via certified mail with delivery confirmation. The company doesn’t play.
First we asked the patient’s family to provide a sitter or family member to sit with the patient the entire time they are receiving treatment to make sure they don’t pull out the needles or get agitated..
It is not the responsibility of the dialysis center to provide the sitter.
At times the patient is given a letter of impending discharge from that clinic with 30 days notice and is given a list of other local clinics for the family to call and arrange a spot and transfer there. Her original center forwards medical records. After those 30 days, however, the patient will not be accepted back in to her original center as it is felt that with the info provided to the family/patient 30 days notice is legal and acceptable and NOT considered abandonment by the dialysis company as the person was given due notice.
However if the family has not followed through providing supervision re sitter request and/or the patient is a physical threat to anyone in that center, discharge can be immediate.
In that case the dialysis patient will need to go to the hospital each time they feel fluid or electrolyte overload to get a treatment and then sent home until next time the need arises. The patient is told to watch their fluid intake and follow the ESRD diet as they will not have a scheduled treatment anywhere and will have to take their own precautions. The onus is on the patient. While the hospital won’t refuse to treat them acutely that person may have to go thru admission paperwork each time they go to the hospital for acute treatment so they have to wait longer like the rest of us and can often die while waiting if the person has not followed their ESRD fluid and diet restrictions.
Its a terrible situation. A huge mess.
Don’t know if the OP will return with more details but if it’s behavioral try to get your mother admitted to a psych ward for medication titration to get those behaviors controlled (or try to).
If dialysis has become unbearable to mom maybe it is time to stop treatment and let her go. For most It’s a miserable existence on dialysis. It could be for her as well. Have a frank discussion with mom if she is able to do so and find out what her feelings are about continuing hemodialysis. She cannot be forced to receive dialysis or restrained during it.
If she is tired of it and wants to stop, call in Hospice who will provide lots of support during end of life.
https://www.agingcare.com/questions/i-am-an-only-child-and-caregiver-for-my-mother-no-family-members-have-stepped-up-to-help-me-in-any-w-459785.htm
We are assuming that she has a form of Dementia. As said, its hard for a Dementia patient to understand what is going on. They can't be restrained. From what I understand it takes hours to go thru the process. The nurses probably can't "babysit". Your other post says something about finding another facility. Since we are from all over the US and other countries, we can't help you find a facility. We r Caregivers sharing our experiences. As said, you need to talk options with her doctor. One option maybe to go on Hospice and allow nature to takes its course. I have a friend who went thru 600 treatments only to choose not to do it anymore. He passed.
I would love more information here. Is your Mom suffering from dementia? Does it manifest with violent acting out? Have her doctors evaluated her for a need for medication (always problematic for someone on dialysis because of the problem with the body functioning being up, down and all over the place).
Is your mother of an age. Does she want to continue dialysis. I am 78. I would not go on dialysis at this point, and were I on it I would stop it and go on hospice with "the good drugs". All of this can go on only so long when the major body systems begin to shut down one at a time.
This is the time for the person who is health care proxy or POA to meet with the doctors and decide if palliative care may not be the way forward. You cannot do any of this on your own.