By Linda Gromko, MD and Jane C. McClure, Interior Designer
This is the third of a four-part series on “Setting Up Your Home Dialysis Unit Without Feeling like You’re Living in an ICU!” We’ve already covered “Top Ten Considerations,” and “Setting Up with Safety First.” In this entry, we discuss the very basics of setting up your unit. Next time, we’ll address storage!
The whole process of dialyzing at home can be daunting at first, but the benefits are well worth the effort. Dialyzing at home can provide the ultimate in personal flexibility – plus, more dialysis and more frequent dialysis which can truly improve the quality of your life.
1. As you start your planning, the first step is to decide where you’re going to set up your unit.
If you’re dialyzing overnight, that’s a no-brainer: you’ll be dialyzing in the bedroom. If you’ll be doing shorter daily treatments, however, you might consider saving the bedroom for your own respite area. You may appreciate a private space away from the medical realities of your lives, where you can feel more like a couple than a patient and care partner!
So, look at your home with a “designer’s mind.” We came up with a number of possibilities that might work for you, too:
· Family Room/Great Room – the perfect place for the person who wants to be in the hub of activity, and a great place to welcome “dialysis-friendly” friends and family
· Guest Room/Spare Bedroom – for the person who’d prefer more privacy
· Dining Room – many homes have formal dining rooms that get little day-to-day use. For the family that tends to eat in the kitchen or family room, this can be a great option – and there are creative ways to conceal dialysis equipment when not in use.
· Den or Home Office – perfect for the dialyzer or care partner who wants to get work done during dialysis runs.
(Do keep in mind Item #7 below, re: placement of waste line!)
2. Take a careful set of measurements of your designated space.
This is where Linda’s eyes glazed over! It’s admittedly a tedious process, but omitting it can result in costly mistakes. Enlist the help of a friend or your partner, grab a metal retractable tape measure (the kind you’d buy at Home Depot), and map your space on graph paper like this:
· Draw the 4 lines that comprise the overall length and width of your room on graph paper
· Add all the areas where the walls change, e.g., closets, recesses in the walls, door entry to the room, and any windows
· Place small x’s on the floor plan drawing to remind yourself where the electrical outlets, cable and phone jacks are located
· When you measure, start in one corner of the room, and continue in one direction around all four walls.
You will want to keep these measurements with you if you plan to shop for additional furnishings like area rugs or window treatments (“drapes” or “curtains” to Linda).
3. Clear out the room!
Almost every re-do begins with a good clean-out. Experts advise that you start this process armed and ready with three boxes for sorting:
· Things to keep
· Things to recycle or discard
· Things to sell or give away.
It will become apparent to you that you will need every inch of storage space you can get, so be brutally honest about what you do and don’t need.
This is also the perfect time to give your room a fresh coat of paint.Youdon’t have the time to do this, but a cooperative neighbor or family member might. Color makes an enormous difference in how we feel – and our emotional “climate” is important in dialysis. We devoted a whole chapter to color in “Arranging Your Life When Dialysis Comes Home: ‘The Underwear Factor.’”
4. Design your furniture layout.
You know, of course, that your space will require the following:
· Dialysis chair
· Dialysis machine on its cart
· Comfortable chair for helper
· Station for monitoring pre- and post-dialysis weights and blood pressures.
Take measurements of each of these pieces. Don’t forget to get a measurement of the dialysis chair when it isfully extended. This point – planning for the dialysis chair to be fully reclined – is a matter of safety. If you need to tip your patient back to stabilize blood pressure, you must be able to recline the chair fully – without hitting another piece of furniture or a wall. Plan for an estimated 7.5 x 9 feet for your chair and “maneuverability footprint.”
5. Establish a Focal Point.
For most homes, this will likely be the wall with the TV, but it might a fireplace or a window. Again, it only matters whatyouwant.
6. Add your other pieces of furniture, working on your floor plan diagram.
This way, you can start over and try a different arrangement!
7. Decide where the waste line will go.
The dialysis waste line must feed into a sink, bathtub, or toilet to drain.
You can hook two waste lines together for more length, and you can actually tunnel through a wall if you know what you’re doing. Jane shows this trick in “Arranging Your Life When Dialysis Comes Home,” but it’s not for beginners!
8. Plan for Waste Management.
Linda and Steve found that large covered baskets lined with plastic garbage bags worked best for actual garbage. Similar receptacles can be designated for recyclable materials. You must have a sharps container for safe disposal of needles. These can be purchased in several sizes at your local pharmacy, if not provided by your dialysis center. (You pay for the medical waste disposal fee when you buy them, or when you return them (full) to the pharmacy.)
9. Take inventory of what you have, and add what you need.
Taking a furniture and furnishings inventory is the next important step. One expert suggested thinking about thisas if you are taking a shopping trip inyour own home. After all, the price is unbeatable!
Be sure to include all your rooms in your shopping trip – not just the room you are planning for dialysis. Include all dressers, office credenzas, buffets, bookcases, and shelving units. Browse through the garage and any storage facilities you have. You might have a classic entertainment center – the kind designed for a large tube TV. While practically obsolete for its original purpose, this may be repurposed beautifully for use in dialysis-related storage. Many older pieces can be made to “blend” with a light sanding and a couple of coats of spray paint; solid black or white can be very versatile. Be sure to record the measurements of pieces you may use.
10. Identify something special that your dialyzer reallylikes.
As you complete your inventory, find something that is special – maybe a framed picture, a souvenir, a decorative box – that your “patient” really appreciates. Anything that makes them feel comfortable or resonates with a special time is appropriate, and important for two reasons:
· It is critical to surround yourself with things you enjoy – especially when life feels so complicated. Your favorite object becomes sort of a touchstone to remind yourself that you’re still hanging in there!
· A favorite object can be the foundation of your color choices, and it serves as your “design reference” – your “jumping off point.”
11. Now it’s time to go shopping – this time, outside of your home.
By this time, you will have taken a good set of measurements of your space – and measurements of the furniture you plan to use. You will have identified an object that is special to you, and you will have begun to think about colors that are pleasing to you. Let’s go shopping!
Make a list of the following:
· Essentials: the things you absolutely need to begin dialysis. Be sure to include task lighting (directed lighting fixtures) if you don’t have these at home
· Items that will help make the environment more comfortable or attractive
· The things that are easy to forget, but critical to have: rechargeable flashlight, roll of duct tape, antiseptic wipes, garbage bags.
When you shop, think first of the places designers shop:
· Furniture consignment stores
· Garage sales
· Salvage shops, particularly for cabinetry
· Any furniture store with the word “outlet” in its name
· Thrift shops: Goodwill Industries, Salvation Army, Value Village
· For new items, consider IKEA, TJ Maxx, Marshalls, Ross
· Import shops like CostPlus or Pier One (great for those garbage hampers and for screens to conceal equipment when not in use)
· Warehouse stores like Costco or Sam’s Club.
That’s a lot of information! But, take it step by step and you’ll find the process will pay off in making your life easier and more comfortable – and your dialysis space more attractive.
Next time, we’ll tackle that elephant in the living room: Storage Solutions!
Linda Gromko, MD is a Seattle family physician who assisted her husband with both hemo and peritoneal dialysis. Jane McClure is a Seattle Interior Designer. Together, they wrote “Arranging Your Life When Dialysis Comes Home: ‘The Underwear Factor,’”available on Amazon.com. They are staunch advocates for the benefits of home dialysis.