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It's approximately 11 a.m. when two Patient Transfer Attendants arrive to pick up 55-year-old Lloyd Rigg at Toronto Rehab-UHN's Bickle Centre and transport him across the city for hemodialysis treatment. He'll return home to Bickle at approximately 6 p.m.
This is a routine Lloyd knows well – it's his third trip this week.
But not for long.
This fall, as part of a $32.3-million multi-year redevelopment project to revitalize Bickle Centre, Toronto Rehab-UHN will open the first nocturnal dialysis program in Ontario for complex continuing care patients with end-stage renal disease.
Dialysis at your door
As a complex continuing care inpatient at Bickle Centre, Lloyd has end-stage renal disease, meaning his kidneys can no longer support his body's needs.
Hemodialysis acts as a filtering system for the blood, removing waste, restoring balance of electrolytes and eliminating extra fluid from the body.
Lloyd is required to travel from his home at Bickle three times per week to receive hemodialysis treatment at Toronto Rehab's University Centre – a process that can take up to four or five hours to complete.
"We're really trying to change the face of dialysis at UHN and provide care that is much more about the individual versus the process," says Dr. Vanita Jassal, Director, Geriatric Nephrology Program at the University Health Network.
"Nocturnal dialysis not only enables us to bring treatment closer to the patient's home - in this case, Bickle Centre - but individuals will now receive it while they are sleeping versus while they are actively enjoying their lives and doing the things that are really important to them."
Nocturnal dialysis offers a longer and slower treatment process, administered over an eight-hour period versus the traditional four-hour period. The hope is that patients will feel less fatigued after this gentler method.
"Our government is proud to support this project, which will enhance safety and accessibility for Ontario's complex continuing care patients," says Dr. Eric Hoskins, Ontario Minister of Health and Long-Term Care. "By revitalizing Toronto Rehab-UHN Bickle Centre's facilities and investing in a new nocturnal dialysis suite, patients will be able to receive hemodialysis on-site versus being transferred to another location, enriching their quality of life, comfort and convenience."
What it means to care for complex patients
Increasingly, people of all ages are living with chronic and complex health issues, such as diabetes, kidney disease, heart disease and Alzheimer's.
In addition to kidney disease, Lloyd also suffers from diabetes, vasculitis and had his leg amputated one year ago due to an infection in his foot.
" As the need for dialysis continues to grow, it is more important than ever to centre our planning around the patient," says Rebecca Harvey, Vice President, Ontario Renal Network. "The redevelopment of the dialysis unit at the Bickle Centre is just one step in our continued work to deliver a coordinated and integrated approach to high-quality kidney care for the patients in Ontario."
Bickle Centre, one of five Toronto Rehab sites, is dedicated to caring for people with complex medical needs. A person's health and ability to live independently can quickly deteriorate, and this individual may need 24/7 support only found in an inpatient setting on a short-term or longer-term basis.
Bickle's team has special expertise in providing care to individuals with complex medical needs in these types of settings, helping patients recover their strength, mobility, manage their disease and improve overall well-being to restore and maximize independence.
"From a staff perspective, having dialysis expertise on-site will be of great benefit to those who provide care to hemodialysis patients," says Julia Kim, Nurse Practitioner at Bickle Centre, Toronto Rehab.
"Having the dialysis on-site will really enable timely intervention and promote continuity between hemodialysis and day-time care at Bickle Centre."
Improving quality of life for hemodialysis patients
The nocturnal dialysis suite will be especially valuable in giving people back their time and maximizing quality of life.
"By providing nocturnal dialysis, these individuals will have more time to do the things that are most meaningful to them," says Dr. Jassal.
"Going out into the gardens, interacting with other residents, spending more time with families or doing things they really enjoy - their quality of life will be so much better."
"Toronto Rehab Foundation is honoured to support this much needed renovation and work closely with our generous donors to help 'Make Incredible Happen' at Toronto Rehab," says Cindy Yelle, President and CEO, Toronto Rehab Foundation.
Lloyd couldn't agree more — he's looking forward to having more time for his favourite day-time activities.
"It will be so convenient because I won't have to be transported anymore — I'll have more time for my music," says Lloyd, who can often be found singing and dancing in his room.
"I love all types of music so it's part of my regime in the day-time. I love to sing choruses and hymns, and dance."
"My other favourite activities are tai-chi, bingo and creative corner. I enjoy making things out of paper like lanterns and different shapes."
In addition to the new dedicated nocturnal dialysis suite, the project will see a transformation of Bickle Centre's facilities to create a supportive environment that inspires health and wellness, while enabling staff and physicians to provide exceptional care.
Updates will include refreshing the inpatient units and outpatient clinics, improving infection control, enhancing patient safety and accessibility, and aesthetic features including exterior brick work and front canopy.
Special thanks to Toronto Rehab-UHN partners for supporting the Bickle Centre Redevelopment project: Ministry of Health and Long-Term Care, Toronto Rehab Foundation and Ontario Renal Network.