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Home care services
Treating people at home in their living rooms, instead of at the hospital, is an approach that can improve quality of life for many patients. “People with severe or chronic diseases often suffer from depression and anxiety. They have the feeling that they are powerless and have little control over their life,” says Heike Spaderna, Professor for Health Psychology at the University of Trier. Being able to choose the treatment time and having more time for yourself and your family can make a big difference in terms of mental health.
B. Braun home care service
Nowadays, more and more therapies are developed to the point that patients can administer them themselves, with assistance from competent professionals. B. Braun is developing various programs to support this trend aiming to offer safe and high-quality home therapy. These include home dialysis in Germany, home parenteral nutrition in Great Britain, at-home stoma care in Ireland and a program for chemotherapy at home in Thailand.
“The key to successful treatment at home is the fact that the patients are not alone. Having family or friends to help out and competent caregivers to monitor the treatment is crucial.”
If these conditions are in place, treatment at home may be an enormous psychological advantage for the patient.
Some patients fear they will only receive second-rate treatment at home. This couldn’t be farther from the truth, as the experiences reported from our home-treatment projects are encouraging.
Dialysis therapy
Claudia and Matthias Hatscher have a special hobby: the married couple in their forties loves Marvel films. They used to go to the movies frequently together to watch 'Iron Man' or 'The Incredible Hulk'. They also visited Cologne’s gaming convention Gamescom every year.
Starting in 2018, this became almost impossible: After a heart attack, and due to various pre-existing conditions, Matthias’s kidneys grew weak. A kidney transplant failed, and he needed dialysis.
“Before something like this happens, you just can’t imagine what it means,” says Claudia Hatscher. More than anything, dialysis means lost time. Patients must visit a dialysis center at least three times a week – and they are not able to choose their appointments. Once there, patients must wait four to six hours before the machines have cleansed their blood of toxic substances. In healthy people, this is a process that is handled by the kidneys. If dialysis patients must work for a living, their life consists solely of dialysis and work. “And traveling back and forth,” adds Claudia Hatscher. “A normal family life was no longer possible. Our three children had just entered adulthood, and we actually wanted to have more time for us again.” Instead, last year, the couple from Baesweiler were running on empty.
But then the Hatschers heard about the possibility of using dialysis at home and got in touch with B. Braun. A medical team handled the apartment modifications for the equipment, while the Hatschers participated in intensive training courses over several weeks. Matthias Hatscher now purifies his blood at home, with help from his wife and a mobile team of caregivers – in a room rebuilt specifically for this purpose.
Claudia and Matthias Hatscher order all the necessary materials using a special app. They receive regular visits from the B. Braun Home Service for equipment maintenance and support. Their dialysis machine is connected to the internet and it transmits all the vital data, such as the patient’s weight or blood pressure, to the doctors at the dialysis center. If there are any problems or discrepancies, the Hatschers can call their dialysis trainer at B. Braun. If this person is not available, a B. Braun service hotline provides round-the-clock reliability. Matthias drives to the dialysis center near Erftstadt (in the Cologne region) only once a month for a checkup.
The majority of dialysis patients are no longer able to work. Their bodies are too exhausted from the dialysis procedure, which often must be carried out as quickly as possible. Matthias Hatscher has been able to continue with his job. He works full-time as a business clerk.
“Home dialysis has major advantages, even from a medical perspective. People who receive their treatment at home are healthier and have better results than patients in dialysis centers.”
The reason for this is clear: in the dialysis center, patients are typically dialyzed three times a week with a one day longer intervall at the weekend. As a result, toxins in the blood rise between treatments, especially during the long break over the weekend. At home, patients can undergo dialysis more often or for a longer period, which shortens the pause in treatments, especially on the weekends. They can easily integrate dialysis into their daily lives. More time for dialysis is not only easier but also an option to reduce stress and feel less worn out.
Home dialysis
Infusion therapy
When patients require parenteral nutrition, they recover better at home than in a hospital. Furthermore, home care patients have also demonstrated better therapy adherence. This means that they can be better prepared to keep up with treatment and, for example, they are less likely to voluntarily stop taking their medication.
Many of the people who rely on this form of nutrition suffer from digestive system diseases, such as intestinal obstruction or esophageal cancer. They are fed intravenously because their digestive system can no longer perform this task. For some, this can be a life-long treatment and they may be happy if they can lead a life as normal as possible.
“Patients who are supported by us at home and give themselves infusions not only have a better quality of life, but they are also less likely to have a relapse of their respective condition and suffer from complications, and they recover quicker overall.”
Home parenteral nutrition
Cancer therapy
One motivation for B. Braun to offer chemotherapy at home was the intention to improve the quality of life of the patients and to develop an option to save resources. This is particularly noticeable in the cancer treatment project in Thailand. The doctors at Bangkok’s Ramathibodi Hospital have been treating some of their cancer patients at home for a few years and saw that they benefit from the experience and infrastructure provided by B. Braun. Patients were not forced to lie in a hospital bed for weeks for the chemotherapy, as it was otherwise still common in Thailand according to the report of the doctors. “Unfortunately, Thailand is also experiencing a drastic rise in cancer cases,” says Phichai Chansriwong, head of the Oncology Department. The hospital’s doctors currently treat around 1,000 cases a year. “On average, 300 more people would actually require chemotherapy.” However, the hospital cannot yet provide more beds and personnel. Doctors have had to send some patients home without treatment.
Hospital treatment is expensive, and personnel costs are high. For the Ramathibodi Hospital, there had to be a solution that could provide good, affordable treatment and saved resources. Three years ago, Chansriwong and hospital director Surasak Leelaudomlipi started the new home care program in the Oncology Department: patients obtain the doses of the medication they need at the hospital or from a pharmacy and then return home. In some cases, they even receive the medication at home. Specially trained nurses, who can be reached via app or telephone at any time, are available to help with questions and problems. Before treatment begins, family caregivers must complete a short training course at the hospital.
Around 600 of the large hospital’s patients are currently receiving some degree of treatment at home. “Since the project began, we have been asking patients about their quality of life, and we have compared the treatment results with those from patients who remain in the hospital,” reports Chansriwong. The home care patients indicate a higher level of satisfaction, and the treatment results are just as good as those for inpatients. “For patients with a terminal illness, treatment at home even extends their life by a few months, on average.” In addition, due to the cost and space savings, more people are able to get the appropriate medical care. More hospital beds are available to patients who desperately need them. The experience has been so positive that hospital director Leelaudomlipi has much more in store: “Our goal is to first implement the program in a neighboring hospital and then nationwide.”
Home chemotherapy
Health care systems in western industrialized nations, such as the USA and Germany, solve the problem by making treatment more efficient: in Germany, for example, the average length of hospital stays shrunk from around 13 days in 1992 to about seven days in 2018. When possible, patients return home as soon as they are able and then receive further outpatient care. This is a better use of resources and, in many cases, an early discharge is a health benefit for patients, as studies show.