Abstract
We assessed factors which prohibit the discharge of elderly patients on chronic hemodialysis (CHD) and evaluated how to prevent or reduce long-term hospital stays. Six elderly patients on CHD, who were hospitalized for more than 6 months, were compared with 6 elderly patients receiving outpatient CHD treatment, with regard to age, duration of CHD, underlying cause of renal failure, complications, and physical, personal and social factors. The degree of physical impairment was scored on the basis of activities of daily lying (ADL), personal problems were graded as to self-management abilities and will, and social problems were classified based on aid and support given by the family, e.g., whether the patient's family accompanied them to the hospital for regular CHD treatments. There were no significant differences in age, duration of CHD, complications or ADL scores between inpatients and outpatients. Inpatients received poorer scores on personal problems than did outpatients. Aid and support given by the family was poorer for inpatients than for outpatients. Continuous education for patients to improve their self-management abilities, step-wise guidance for discharge, and aid and support provided by the family may play key roles in reducing long-term admissions of elderly patients on CHD.
