Table 3

Strategies and recommendations to promote the acceptability of home haemodialysis among patients and family caregivers

StrategyAction plan
Education
  • Discussions about treatment options for end-stage kidney disease that include home haemodialysis should be tailored to the existing haemodialysis experiences of patients and their families

  • Meet other patients on home dialysis therapies (haemodialysis, nocturnal haemodialysis and peritoneal dialysis) to listen to their experiences

Minimise intrusiveness of home haemodialysis
  • Use home haemodialysis machines that are less conspicuous (small sized and portable) and require minimal home modifications

  • Promote awareness about home haemodialysis machines that are smaller and easy to operate

  • Provide practical tips on minimising the visibility of home haemodialysis within the home

Provide support and respite for caregivers and family members
  • Increase awareness of home haemodialysis equipment that require minimal or no caregiver assistance

  • Identify and implement a forum for patients and families/caregivers to discuss experiences and decisions (online/physical)

  • Appoint a dedicated mental health worker in the clinical team

  • Ensure access to social work services (caregiver respite and allowance)

  • Network with caregiver or consumer organisations and identify respite and support services for caregivers and families

Maintain patient access to medical and technical support
  • Offer home visits as determined on an individual, need-by-need basis

  • Provide 24 h availability (eg, hotline) of clinical and technical staff

Minimise social isolation
  • Organise forums or social events for patients and caregivers (eg, face-to-face, telephone and web-based contact)

  • Consider set up of community homes for haemodialysis

Promote self-efficacy
  • Use home haemodialysis machines that are intuitive and simple to configure, programme and disconnect

  • Provide comprehensive and timely home haemodialysis education and training (eg, individual training, forums, question and answer sessions and print and multimedia resources)

  • Encourage the importance and benefits of independence and self-care

  • Recruit home haemodialysis ‘patient exemplars’

  • Facilitate opportunities to learn from patients who are successfully performing home haemodialysis