The entire family participates in the success of the home dialysis patient. Isolation and study of discrete quantifiable aspects of behavior within the family may allow identification of patients with a greater risk of failure, thus making it possible to help such patients succeed. A single such factor, ‘intrafamily identity’, measured in each of 40 diverse families before one family member began a home dialysis program, was found to correlate with success in the program 1 year later. This finding also may contribute to an understanding of systematic patterns of behavior within all families, with special emphasis upon the ability of family members to cope with continuing stress.
Those responsible for the planning of new comprehensive community mental health centers providing short-term hospitalization should realize that about one-third of all patients using inpatient services will have to use them more than once, and this may eventually compromise the center's availability to new patients. If separate administrative structures exist for the center and the state hospital system, close cooperation between the two will be essential. Ninety-two of 395 patients in this study eventually needed long-term care.
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