Dialysis admin: the schedule, the transport and the rota

The schedule page, and the driver beside every slot

Write the schedule out as a month view and put it on the kitchen wall. Days, arrival time, expected finish time, location, and — the part families skip — the name of the person taking your parent and the name of the person collecting them.

Arrival and finish are different from the treatment time, and the difference is what makes a driver late. Ask the unit what time to arrive, how long the session runs, and how long afterwards to allow before leaving. Write the real door-to-door figure, not the optimistic one.

Add the practical facts: which entrance, where to park, whether there is a drop-off point, and whether a wheelchair is available at the door.

Print two copies, photograph one, and give a copy to everyone in the rota. A schedule that only one person can see is not a rota, it is a memory.

• Month view on the wall, plus a photograph on every driver's phone
• Days, arrival time, expected finish, location
• Named driver out and named driver back, for every session
• Real door-to-door time, including waiting afterwards
• Entrance, parking, drop-off point, wheelchair availability
• The unit's direct number and the number for running late
• A note of who to tell if a session is missed, and how

Transport: learn the booking rules and write them down

Whether transport comes from a service, a family member or a taxi, the failure is almost always administrative: booked too late, cancelled wrongly, or nobody knew who was doing it.

Ask the unit's social worker what transport arrangements exist for your parent, what they cost and how they are booked. Then write down the rules exactly: how many days ahead, by phone or online, the cut-off time, the reference number system, and how to cancel without penalty.

Book the whole block ahead rather than week to week, and put the booking reference beside each session on the schedule page. Set a recurring reminder for the day bookings must be made.

Keep a log of failures — date, what went wrong, who you told. If a service is unreliable, that log is what you take to the social worker, and it works far better than a complaint made from memory.

• Transport service name, phone, and hours
• Booking notice required, cut-off time, and how to book
• Booking reference against each session on the schedule
• A recurring reminder on the day bookings must be placed
• How to cancel, and any penalty or notice rule
• Cost per trip, and whether it is covered
• A failure log: date, what happened, who was told

The unit contacts, and the social worker in particular

Kidney units in the US usually have a social worker attached, and for a family that person is the single most useful administrative contact in the building. They handle transport, insurance questions, travel arrangements and the paperwork nobody else has time for.

Ask for their name and direct number and write it at the top of the contact page. Ask what they can help with and what they need from you — most families discover this service years later than they should have.

Build the rest of the page around roles: the unit desk, the charge nurse, the dietitian, the nephrologist's office, and the number to call outside unit hours. Note the hours beside each, because most of them are not reachable in the evening.

Ask one administrative question and record the answer with a date: how does coverage work in my parent's case, and who at the unit can explain the paperwork. That question belongs to the social worker and the insurance plan, not to you.

• Unit social worker — name, direct number, hours
• Unit desk and the number for running late
• Charge nurse, dietitian, and the nephrologist's office
• Out-of-hours number, in large print on the fridge page
• Insurance plan, member number, and who at the unit explains the paperwork
• Monthly review or care conference dates, if the unit holds them
• The date you last checked every number on this page

Home treatment: deliveries, storage and the utilities

If treatment happens at home, the household becomes a small warehouse with a delivery schedule, and that is entirely an admin task.

Record the supplier, account number, delivery day and cycle, what a standard delivery contains, where each item is stored, and the reorder point. Photograph the storage area so anybody can check stock without knowing what they are looking at. Note the driver's access instructions.

Call the electric and water companies and ask about programs for households with medical equipment — advance notice of planned outages, priority reconnection, a note on the account. They usually need a form signed by a clinician. Write down the program name, what it needs, the date sent, the reference number, and the renewal date.

Ask the unit what to do if a delivery is missed or a machine alarms, and file their written answer. Do not compose that page yourself.

• Supplier, account number, delivery day and cycle
• What a standard delivery contains, and the reorder point
• Where each item is stored, photographed
• Delivery access instructions for the driver
• Electric and water company programs: form, date sent, reference, renewal
• The unit's written instructions for a missed delivery or an equipment alarm
• Machine make, model, serial number, and the service number

Splitting it between siblings, in writing

A dialysis schedule is the clearest case in caregiving for a written rota, because the commitment is fixed, repeated and visible. That makes it easy to divide fairly — and easy to see when it has not been.

List every recurring task: the drives out, the drives back, the waiting, the shopping, the prescription collections, the calls to the unit, the paperwork. Put names and dates against them for the next eight weeks and circulate the page.

Agree how a swap works before one is needed: who to tell, by when, and where the change gets written. Verbal swaps are how sessions get missed.

Keep a shared cost ledger with dates — fuel, parking, fares — and settle it monthly rather than annually. And write a handover pack for the week somebody else covers: the schedule, the contacts, the booking rules, the medication record, and the what-if page.

• Every recurring task listed, including waiting time and phone calls
• Names against dates for eight weeks ahead, circulated
• An agreed swap procedure: who to tell, by when, where it is recorded
• A shared cost ledger, settled monthly
• A written handover pack for anyone covering
• One short family call a month with a written agenda
• A named backup driver for every session

Questions