Home parenteral nutrition: the "costs" of patient and family participation.

The continued advancements in technology and medicine now make it possible for patients who are nutritional "cripples" to thrive on an outpatient basis through home parenteral nutrition (HPN). Since the social and psychological literature does not yet reflect extensive information on this type of program, this article outlines in detail a successful HPN program and explores the personal factors and needed resources involved in participation in such a program, including the perils of third party reimbursement. Based on experience in evaluating 36 HPN candidates and working with 26 HPN participants, the salient problems and concerns patients and families encounter with HPN therapy are discussed along with suggestions for constructively addressing such issues.