Thinking outside the box: an extraordinary woman on home peritoneal dialysis.

At the home peritoneal dialysis unit (HPDU) of the University Health Network in Toronto, Ontario, we offer training to help patients perform peritoneal dialysis at home with ongoing support, which includes clinic visits and on-call services. Not every patient is able to carry out independent dialysis, however. Additional support at home is often provided in conjunction with Community Care Access and home care nurses. We recently had the privilege to learn from an extraordinary patient, whose special needs provided us with challenges and opportunities. This paper describes the interaction, flexibility and creativity between our unit, home care nurses, the patient and her family. It demonstrates that with commitment, there truly are many ways to solve even seemingly impossible problems.