My grandma recieves dialysis and a couple of days ago she pulled her needle out and bled all over and even became unresponsive for a few seconds. I was told that going forward it will be mandatory to have someone with her. I am looking into a companion to sit with her during treatment. Everywhere I call it's $32+/hr in addition to transport and requires 4 hrs minimum. That is more than what I make but I will also be using my grandma's funds. Do you know about places that work with insurances? My grandma has Medicare A and B and Blue Cross Supp. Social worker can't do much but suggested I hire someone on my own but I have no one. We live in CA.

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"Unfortunately all she has suggested is to look for a friend or family member to assist "

That's not much help! What friend or family member is going to suddenly appear and give up 4 hours 3 (?) days/week?

I take it you have a job. From your profile, your grandmother appears to need a lot of help. Does she have a caregiver at home? Does she live with you? Do you do caregiving when you are not at work?

What are you going to do the next time she needs dialysis? I feel so badly for you. Please keep us updated!
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Unfortunately that is common practice in a US Dialysis center.

There are staff to “watch” her but they are responsible for watching everyone, & it’s impossible to do that 1:1 in a dialysis center. This is why they have made that request. No, it’s not the SW’s responsibility in this case.

It is similar to when a NH management recommends the family secure a “sitter” due to inability of staff to watch a person 1:1.

This “sitter” doesn’t have to be a CNA, just a person to watch to make sure your grandmom doesn’t pull out her needles. I have worked in dialysis clinics and believe me, someone can pull a needle out in a second and the patient can have already lost a lot of blood even before the machine alarms ( I mean in 2-3 minutes as the machine WILL alarm in that time).

Dialysis centers are regulated by CMS Conditions of Coverage. While I was well versed in these regs during my dialysis days (RN Charge Nurse @ Clinical Manager) I am unfamiliar with any changes since I left that field 6 yrs ago but yes, we were allowed to ask a family member or sitter to watch over a patient known to pull out her lines.

I only hope that having dialysis 3x a week, which is arduous at best for a younger dialysis patient, is improving your grandmother’s quality of life. The dialysis process for a patient is exhausting.

If she has pulled her needles she DOES need 1:1 while at the center, & this is not an unreasonable request from the SW. Medicare covers ESRD patients if they or their spouse qualify @ 80%. If any additional sitters are needed, yes it’s an out of pocket expense. Medicare will not pay.

Explore your church for volunteers or arrange to pay them at least $10 an hour or donate to their church. The sitter does not have to be a professional paid licensed staff person.

Its scary when when someone pulls their needle. Blood goes everywhere. The dialysis center must protect other patients & staff from getting sprayed with blood. The dialysis clinic staff are unable to watch them 1:1 as often other patients are arriving to start treatment or getting rinsed back for discharge.

The chance of exsanguination is a definite possibility. I have seen patients pass out as your grandmother did & it’s because of low BP due to blood loss. Fortunately in the 20 yrs I worked dialysis it never happened that someone passed away from exsanguination. Other reasons, yes.

Again the person doesn’t have to be licensed; qualifications of the person is important if only for accountability. In other words, choose someone who you know is an astute observer and patient enough to sit in a dialysis center for 4/5 hrs & not get bored.

Our dialysis company (one of the big 2 in the US) had a requirement that the patient not cover the access arm so the staff could see the lines easily. This policy was written to assure precautions were taken to prevent episodes like this. We asked our patients to sign an acknowledgment of this policy simply to educate them about the risks of exsanguination & the importance of keeping the lines uncovered. Many signed and then went back to covering the access up with blankets, etc.

Good luck!
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I don't understand why the Social worker "can't do much". Isn't that her job? If its mandatory to have someone with her, than they need to provide that or have grandma spend her assets down to qualify for assistance. What you need to do is use her money to pay for the care until she qualifies for the state Medicaid program. The social worker should be able to help with that, isn't that what she is supposed to do? (If I'm wrong, somebody please correct me). You should not be paying your money for her care.
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ineedsupport32 Jun 2019
Unfortunately all she has suggested is to look for a friend or family member to assist or start calling agencies that accept insurances. I started crying because I am just so overwhelmed and only thing she offered was a "I am sorry". I was also hoping for further assistance. She is a social worker at the dialysis place and helped get me started with day care service for my gmom when she is not in dialysis.
You could try her suppliment and see what they provide.

Check the local Nursing/community college. See if a student wants to "babysit" Gma. CNAs sometimes are trained out of Technical Schools. Try there.

Where are ur gma's children?
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Medicare won’t pay for a companion.

The cost to hire one will vary throughout the US.
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