Traditionally the high dependency patients needs have been managed in hospitals and nursing homes. With increasing demands upon our health and aged care facilities sending clients home with high care needs is becoming a necessity.

Some families choose to care for their loved ones at home. This case study is of a high dependency peritoneal dialysis patient who was an inpatient for several months and opted to go home where her aging husband was happy to care for her. This patient had numerous co-morbidities including t2dm on insulin, a left arm amputation and right leg amputation, necrotic left breast, all requiring complex dressings.

Strategies where put in place so this could be achieved safely. A multi-disciplinary approach was initiated. Liaising with medical and nursing staff, social workers and occupational therapist to ensure that appropriate follow up could be maintained in this rural district was achieved. Bariatric equipment including hoist, shower chair, hospital bed, lounge chair and the necessary modifications to the home where made.

The husband was educated to use the equipment and manage automated peritoneal dialysis. Domiciliary nursing care was established to assist with hygiene cares and complex dressings. Community links were established and the Discharge was a success.