Managing homeless dialysis patients.

Although our dialysis facility is located in a rural area, we noticed an increasing number of homeless patients requiring treatment. After researching the issue of homelessness in dialysis patients, we found little has been reported on the subject. We examined the characteristics of our homeless dialysis patients as well as the effects these patients have on the multidisciplinary dialysis care team. Six homeless patients were dialyzing in our in-center hemodialysis unit (monthly census averages 105-110 patients) in April 2005. All of the homeless patients were men; five of the six were African American, five had a history of substance abuse, and four a history of alcohol abuse. The mean age of these patients was 45.75 years, and the mean number of months on dialysis was 46.4. All were single (5 divorced, 1 never married), and 5 had a history of psychiatric illness. All six had Medicare coverage. The patients found shelter through local community shelters, the Salvation Army, and in their automobiles. The medical, nursing, dietary, and social aspects of the care provided by the dialysis multidisciplinary team members are discussed as it pertains to the care of homeless dialysis patients.