Total Care for Patients of Chronic Renal Failure

Abstract

Center established in 1971 now treats 87 in and outpatients with chronic renal failure at its dialysis department during day and night hours under Hospital dialysis I. C. U. (Intensive Care Unit) and L. C. U. (Limited Care Unit) systems. After the fatients had received guidance on diet and water control other than dialysis in daily life at the dialysis department, the treatment team started to make homecare visits in 1976 in an attempt to establish closer communications with the patients and their families. As a result, the patients' volition toward self-control and social rehabilitation was much improved with the cooperation and understanding of their families. The subjects involved are the patients now receiving dialysis treatment, and the number of calls made since the start of home-care visiting reached 108 cases in December 1979. The members of the treatment team made it a rule to hold a meeting before making home-care visits, each visiting group consisting of 3 persons, i.e. head nurse, nurse-in-charge and dietician, the necessary guidance being issued at the patients' homes regarding their daily life and dietary schedules. Results (1) Singificant improvement of anemia was recognized. Mean Ht. and mean Hb. levels as low as 20.3% and 6.9%, respectively, before home visiting, showed an increase of about 6% (up to 26%) in the former and about 1.69d/dl (up to 8.5g/dl) in the latter, 6 months after visiting. (2) Both emotional stability and life adaptability were found favorable in psychological tests carried out after visiting, while attitude of the patients proved to be more positive. (3) The rate of social rehabilitation has now registered a level of 70% at this hospital. Although the treatment team has repeatedly visited the subjects' work places and schools, the vocational rehabilitation has yet to be imporved in view of a lack of understanding and interest on the part of the community. Thus, we medical staffs