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Seniors' Health: Program helps older dialysis patients remain independent

Many people with failing kidneys are elderly and need assistance with exercise and diet

Going on dialysis is a lifesaver for someone with failing kidneys, but for older people the treatment might not be enough to keep them out of a nursing home. A special program in Toronto is working to change that.

Developed by the Ontario Ministry of Health, the University Health Network and the Toronto Rehabilitation Institute, the program focuses on keeping older patients independent as they undergo the regular dialysis treatments, which remove toxic substances from the blood when the kidneys are unable to do so.

Dr. Vanita Jassal heads the 12-patient dialysis unit at the rehabilitation institute's downtown site. She says more and more elderly patients are being put on dialysis and often need help with their daily activities. In fact, about 25 per cent of new dialysis patients are older than 75.

Patients are sent to the institute for an average of six weeks with the aim of restoring their mobility and the ability to care for themselves. Since it opened in 2001, the dialysis unit has treated about 250 patients, and 70 per cent were discharged from hospital.

"We would have been looking for nursing homes for a lot of these patients," Jassal says. Knowing they will be headed home after their six-week stint at Toronto Rehab is a boost to their confidence -- which results in better outcomes.

Jassal says one of the keys to that success has been changing the dialysis regimen from the normal four-hour session three days a week to two-hour sessions six days a week. It means patients are inactive for shorter periods each day, and have better control of blood toxins -- which allows dietary restrictions to be eased. "You can eat an egg or a piece of cheese, which might have been forbidden."

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