Living with home-based haemodialysis: insights from older people

Aims and objectives. To understand the challenges older people living with end-stage kidney disease and home haemodialysis face in their everyday life. Background. As the treatment of end-stage kidney disease has advanced, two aspects have emerged; increased life expectancy of end-stage kidney disease patients and psychosocial adaptation to a changed life. There is limited information regarding older peoples' experiences of adaptation to end-stage kidney disease and home haemodialysis. Design. This qualitative study took place in Australia and involved participants who were over 60 years of age and undergoing home haemodialysis. Methods. Four participants aged between 60-75 years, with end-stage kidney disease and currently enrolled in a programme of home haemodialysis took part. Data were collected via in-depth audio-recorded interviews and subjected to a qualitative thematic analysis. Results. Three themes were generated that provide insight into participants' everyday activities, significant relationships, challenges and hopes for the future. Conclusion. Findings indicated a transformed care dynamic, positive appraisal and active everyday engagement by participants. A positive outlook on life in the present enabled participants to look to their future with purpose and hope. Outstanding systems of partnership significantly facilitated this view. Relevance to clinical practice. Knowledge from the study may contribute to the development of patient-care partnerships that facilitate and promote independence for older people being treated for chronic illnesses.