In-Home Dialysis Care Explained: Types, Costs, & Support

Dialysis is life-saving, but it’s also life-changing.

Multiple trips to the clinic each week can take over your schedule, leaving you drained and worried about missing a session.

In-Home dialysis care can ease stress and save you time. It may also leave you with more energy and fewer restrictions on your daily routine.

This guide will show you what home dialysis looks like day-to-day, the two main treatment options, and how Helpers can make treatments safer and smoother so you can manage them with confidence over the long term.

What Is In-Home Dialysis Care?

In-home dialysis means you receive treatments at home instead of traveling to a clinic multiple times a week. The same life-sustaining process happens in a familiar space, with more control over your schedule.

Here’s how home dialysis feels different from clinic care:

• Flexible scheduling: Plan treatments around your routine, not clinic hours.
• Comfortable environment: Recover in your own space instead of a medical facility.
• Support nearby: Have family, friends, or a Helper with you during treatments.
• No commute: Skip the frequent trips back and forth to the clinic.

The treatment itself is the same. A machine filters waste and excess fluid from your blood, then returns the cleaned blood to your body. The difference is that at home, you decide when dialysis fits into your life.

Why Home Dialysis Is Growing in Popularity

More people are choosing home dialysis every year. National kidney data show steady growth over the past decade, with the share of people using home dialysis climbing from roughly 10% to about 15% of all dialysis patients. (Source: USRDS)

Many people who choose the in-home dialysis route report:

• Better blood pressure control: More frequent, gentler treatments support heart health.
• Fewer food limits: Home dialysis makes it easier to enjoy a more flexible diet.
• More energy: Many people feel less tired after treatment at home.
• Lower hospital visits: Consistent treatment schedules reduce emergency care needs.

Home dialysis also cuts out the weekly clinic trips—usually around 3 per week—saving you time and transportation costs. You set the schedule, so treatment works with your life instead of against it.

Note: These benefits reflect what many studies and patient experiences have shown, but every person’s situation is different. Your care team can help you decide if home dialysis is the right fit for you.

Is Home Dialysis Right for You? Eligibility & Home Setup

Not everyone can start home dialysis right away. To move forward, you’ll need to be medically stable and have the right setup at home.

Here’s what your care team will review before clearing you for training.

Your Health and Abilities

You may be a strong candidate if you:

• Have stable overall health
• Can see clearly and use your hands well enough to handle equipment
• Stay organized and follow step-by-step instructions
• Feel confident managing schedules and keeping records

If this sounds like you, your team will likely approve you to begin training.

Your Home Environment

The space where you do treatments matters too. Most people need:

• A quiet, clean area set aside for dialysis
• Steady electricity and running water
• Storage space for several weeks of supplies
• A plan in case of power or water outages

When these basics are covered, your treatments are smoother and less stressful.

Infection Prevention Basics

Dialysis works only if infection control is taken seriously. During training, your clinic will show you and your Care Partner how to:

• Wash hands carefully before every step
• Keep surfaces and equipment clean
• Watch for early signs of infection
• Use sterile technique exactly as taught

It might feel strict at first, but over time these steps become second nature and protect your health.

Quick Checklist

Before training, ask yourself:

• Do I have stable health and steady hands?
• Is there enough space and storage at home?
• Do I have reliable power and water?
• Am I willing to follow infection-control steps every time?
• Do I have a loved one or professional caregiver who can be my Care Partner for treatments?

If you can answer “yes” to most of these, you’re in a strong position to succeed with home dialysis.

Understanding Your Home Dialysis Options

There are two main types of home dialysis, each working differently to clean your blood and remove excess fluid.

Your medical team will help you choose the best option based on your health, lifestyle, and personal preferences.

Let’s walk through how each type works and what to expect.

Home Hemodialysis (HHD)

Home hemodialysis uses a machine to filter your blood outside your body. Blood flows through tubes to a dialyzer (artificial kidney) that removes waste and extra fluid, then returns clean blood to your body.

This treatment needs vascular access, such as a fistula, graft, or catheter, to let blood flow in and out during treatment.

The process is similar to clinic hemodialysis but happens in your home with a smaller, more user-friendly machine.

Treatment schedules are flexible:

• Short daily sessions: 2-3 hours, five to six times per week
• Nocturnal treatments: 6-8 hours while you sleep, usually every other night
• Standard schedule: 3-4 hours, three times per week (like clinic dialysis)

Home Peritoneal Dialysis (PD)

Peritoneal dialysis uses the lining inside your abdomen (peritoneal membrane) as a natural filter.

A catheter placed in your belly allows dialysis fluid to flow in and out, cleaning your blood without any needles during treatment.

There are two main approaches:

• CAPD (Continuous Ambulatory Peritoneal Dialysis): You manually exchange fluid 3-4 times during the day
• APD (Automated Peritoneal Dialysis): A machine does exchanges automatically while you sleep

PD must be done daily to stay effective. Many people like this option because it's needle-free and can be done almost anywhere that's clean and private.

Some people opt to have a family member help out with their home dialysis, but that’s not always possible for everyone. Sometimes professional expertise is easier or more convenient.

You can find Helpers on the Herewith platform to support both types of home dialysis.

What Helpers and Care Partners Do at Home

Support at home can look different depending on the type of dialysis you choose.

Some patients work with a clinic-trained Care Partner, while others bring in a Helper for supportive, non-medical care.

Both roles are important, but they aren’t the same. It’s common to rely on both types of help, so you have medical and day-to-day support covered.

Clinic-Trained Care Partners

For home hemodialysis, many programs require a Care Partner. This is usually a family member or professional caregiver or Helper who completes training through your dialysis clinic. A Care Partner may:

• Assist with treatment setup under nurse instruction
• Help monitor the machine during sessions
• Keep records as directed by the clinic
• Respond to issues using the plan you and your team create

A Care Partner is part of your medical team, and their duties depend on what your doctor and dialysis nurse allow.

If you’re interested in professional in-home dialysis treatments, ask your clinic if they partner with Herewith for dedicated in-home dialysis Care Partners.

Helpers Booked Through Herewith

In addition to finding Helpers to be your Care Partner on Herewith, you can also book Helpers for more general care. Helpers can support your daily routine around dialysis. They focus on the tasks that make treatment days easier, such as:

• Driving you to and from clinic visits
• Organizing your treatment space and supplies under your direction
• Preparing light meals that fit your diet plan
• Noticing changes in how you feel and sharing updates with your family or clinic
• Assisting with transfers or mobility
• Offering companionship during or after treatment

Helpers do not perform sterile procedures or make medical decisions. Their role is to keep your home environment safe, comfortable, and well organized.

Knowing these boundaries makes it easier to decide what kind of support you need at home.

The Training Process: What to Expect

You won’t be on your own when you start home dialysis. Your clinic will guide you step by step until you feel confident managing treatments at home with your chosen Care Partner.

Training usually lasts a few weeks to a few months, depending on the type of dialysis and how quickly you and your Care Partner feel ready.

During this time, you’ll work closely with dialysis nurses and technicians at your clinic.

You’ll learn:

• How to set up, run, and care for your dialysis equipment
• Safety checks and what to do if something feels off
• Infection-prevention steps to keep your access site clean
• Simple record keeping, like logging treatment times and fluid removal
• Emergency protocols and who to call if you need help

Most programs ask both you and a Care Partner to complete training together, so you always have backup during treatments.

When training is finished, many people choose to bring in a Helper for extra support at home. While Helpers don’t provide medical support, they can handle daily care tasks, transportation, and companionship so treatments feel less overwhelming.

How Respite Care Supports Dialysis at Home

Dialysis is ongoing care. Treatments happen several times a week, often for years, and that pace can wear down even the most devoted caregiver. Respite care gives your family time to rest while keeping you safe and on schedule.

Here are a few ways Helpers can step in:

• Workday coverage: If your spouse or family member needs to be at work during treatment hours, a Helper can drive you, stay during your session, and help with recovery afterward.
• Overnight support: For nocturnal hemodialysis, a Helper can stay nearby so your family gets a full night’s sleep without worry.
• Morning cleanup: A Helper can help you get settled after an overnight hemodialysis session, handling light cleanup and making sure your space is ready for the day.
• Short-term relief: Helpers can cover treatments when your usual caregiver is sick, traveling, or just needs a break.

When you use respite care strategically, your caregivers get the rest they need, and you never have to miss a treatment.

What Does In-Home Dialysis Support Cost?

Most of the medical side of dialysis is covered by insurance or Medicare. This usually includes your machine, supplies, and training—and sometimes respite care as well. Families rarely pay for these pieces out of pocket, but you’ll need to check with your insurance about deductibles, co-pays and coverage.

What isn’t covered is the extra help that makes dialysis at home easier and safer. Helpers who drive you to appointments, organize supplies, or stay with you during treatments are paid privately.

Here’s how the costs usually break down:

• Medical care and training: Typically covered by Medicare Part B at 80%, with the rest billed to you or a supplemental plan.
• Supportive Helpers: Paid out of pocket, usually $25–$45 per hour depending on location, experience, and whether the shift is daytime or overnight.
• Transportation: Costs vary if you use a Helper for rides, paratransit, or non-emergency medical transport. Some options are covered by insurance, some are not.
• Home setup: Most homes only need minor adjustments, but families sometimes add storage or backup power, which can increase costs.

Every situation is different. The best place to start is with your dialysis clinic, since they can tell you exactly what’s covered and where you may need to budget for extra support.

Making the Right Choice for Home Dialysis

Deciding on home dialysis is a big step. It shapes your daily routine, family life, and long-term health. Your medical team will help you decide if it’s safe, but the choice also depends on what feels realistic for you.

Here are a few things to weigh as you make your decision:

• Your comfort level: Are you ready to take on the responsibility of managing treatments at home?
• Your home setup: Do you have enough space, reliable utilities, and a clean area for treatments?
• Your support system: Is someone available to help during treatments or in case of emergencies?
• Your lifestyle goals: Will flexible scheduling help you keep working, traveling, or staying active with your family?
• Your health stability: Has your doctor confirmed you’re a good candidate for home dialysis?

Taking time to think through these questions will help you decide if home dialysis is the right fit for your health and your life.

Ready to Find Support for Home Dialysis? Two Ways to Book Helpers

If you move forward with home dialysis, the next step is finding the right support. On Herewith, you can do this in two ways:

Through your dialysis clinic: Some clinics work directly with Herewith to provide trained Helpers who can assist with treatments. If your clinic offers this option, they’ll guide you through the process.

By booking directly: You can also connect with Helpers directly online or through the Herewith mobile app for flexible support. This might include transportation, organizing supplies, meal prep, companionship, or staying nearby during overnight treatments.

Both paths give you peace of mind. With consistent support, you can stay on track with treatments, ease the load on your caregivers, and keep your focus on living your life.

Families Also Ask:

Is it better to do dialysis at home?

Home dialysis can give you more flexibility, better blood pressure control, fewer diet limits, and higher energy compared to clinic treatments. It isn’t right for everyone, though. Your medical team will help you decide if it fits your health, home setup, and support system.

Will Medicare pay for a Care Partner to help with home dialysis?

Medicare covers most of the medical side of dialysis, including your machine, supplies, and training. It does not cover Helpers who provide non-medical support, with the exception of some forms of respite care. That kind of help, such as transportation, companionship, or setting up your treatment space, is usually paid out of pocket.

How often do you do dialysis at home?

It depends on the type of dialysis you use. Home hemodialysis can be done three times per week, in shorter daily sessions five to six times per week, or overnight every other night. Peritoneal dialysis must be done every day to stay effective. Your doctor will recommend the best schedule for your needs.

What’s the difference between home dialysis and in-center dialysis?

The main difference is flexibility. In-center dialysis happens on a fixed schedule three times a week at the clinic. Home dialysis lets you decide when treatments happen in your own space. Both clean your blood effectively, but home dialysis often allows more frequent sessions, which can support better overall health.

Can family members be trained as Care Partners?

Yes. Family members can go through training with you and act as Care Partners. Many programs encourage this so someone close to you understands how to set up, monitor, and safely support your treatments.

What happens if something goes wrong during home dialysis?

Your clinic training will cover exactly what to do in an emergency. Always contact your dialysis team or healthcare provider with any questions or concerns. Having a Care Partner or Helper with you adds another layer of safety if you need someone to help make phone calls or contact an emergency number.