Daytime or night-time condition
References to ‘day’ and ‘night’ do not relate to specific times of the day. Instead, they are based on the ordinary domestic routine of the individual’s household (PADP regs, reg 2). For more information, see the PADP – Definitions chapter.
Where an individual undergoes renal dialysis by day and night, they can only satisfy either the daytime or night-time condition, not both (PADP regs, reg. 7(1)(c))
This means that individuals receiving PADP due to the rules for renal dialysis are only eligible to receive the lower rate of PADP.
However, where an individual satisfies the rules for renal dialysis and also has other needs due to another condition, the case manager should consider this condition when making a determination of entitlement. This is set out in more detail in the ‘Dialysis and other needs’ section of this chapter.
Example: an individual receives renal dialysis during the day
Elizabeth is 82 years old and starts her haemodialysis when she goes to bed around 6pm. Her husband sets up the dialysis and stays with her until she is settled. The haemodialysis lasts approximately four hours.
Her husband checks in with her from time to time until the dialysis has ended, which generally is around 10pm. Afterwards, he:
- helps Elizabeth use the bathroom if she needs it, as she tends to feel dizzy after dialysis and could hurt herself without support
- disconnects the tubes and cleans the dialysis machine, which takes him around 30 minutes
- goes to bed around 11pm
As Elizabeth’s husband prepares and supervises the dialysis before he would normally go to bed, his night-time routine is not impacted by Elizabeth’s treatment. Therefore, Elizabeth has satisfied the daytime condition and is entitled to the lower rate of PADP
Example: an individual receives renal dialysis during the night
Murray is 87 years old and had been receiving haemodialysis during the day at his local hospital for over 2 years. However:
- Murray often felt distressed by having to attend the hospital
- he also required his partner, who is his carer, to drive him to and from the hospital
Murray therefore started to receive dialysis at home during the night. Murray’s partner has been trained to assist him by the hospital. Murray’s partner has made an application for PADP on his behalf. His partner has had to change their night-time routine to help Murray with his dialysis:
- Murray’s partner sets up the dialysis once Murray is in bed, usually around 9pm
- Murray’s partner will stay with him until he is asleep, usually around 9.30pm
- Murray’s partner checks in on him during the dialysis, which takes approximately four hours
- once Murray’s dialysis has finished, his partner will clean and put away the machine and tend to Murray, such as helping him to get to the toilet
Murray’s partner now goes to bed around 1.30am once they have finished tending to Murray. The case manager decides that Murray’s dialysis satisfies the night-time condition. Murray is entitled to the lower rate of PADP because:
- Murray’s partner provides attendance and supervision when administering Murray’s dialysis
- the majority of Murray’s dialysis treatment therefore takes place after the household bedtime.