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What is a support person?
The Veterans Health Administration (VHA) requires that every kidney transplant candidate have a support person. The support person is a relative or friend who is committed to helping you, the transplant candidate, throughout the workup process, during your on-site evaluation, at the time of your transplant surgery, and in the months following your transplant. The VHA also requires you to have a backup support person, in case your primary support person is unavailable due to illness or other circumstance.
Why is a support person required?
Over the years, numerous studies have looked at the success rates of transplant recipients. This research has shown that recipients who have good social support tend to have better transplant outcomes than those who have no social support. We know that unfortunately not all kidney transplants are 100% successful and that some patients may experience complications. Having a caring support person can make a big difference in your emotional well-being and in helping you cope with any complications.
If I already have a support person, why do I need a backup support person?
Should your support person happen to be ill at the time of your transplant surgery, we would ask that person to remain at home. We do not want others to pass their illness onto you. Instead, your backup support person would come to the VA Iowa City Health Care System Medical Center with you and be your support person.
What does the VHA Directive say about support persons?
The VHA Directive requires ".a firm commitment from a relative and/or a friend for support before, during, and after the transplant procedure. The support person is expected to go to the VATC [VA Transplant Center] with the patient for evaluation and the transplant episode, provide post-transplant support, accompany the patient to follow-up appointments, assist with medications, ensure compliance, and offer general assistance."
Who can be a support person?
The support person can be any person with whom you feel comfortable, such as your spouse, partner, relative, or friend. This person must be committed to you and your transplant success.
What should be considered when selecting a support person?
When deciding whom to choose for your support person, you will need to consider the following:
- minimum age of 18
- must be available to attend the on-site evaluation with you
- must be available to assist you at the time of transplant
- must have no active substance abuse issues (no alcohol or illicit drugs)
- prefer no drinking alcohol or smoking in your presence
- must be mentally and emotionally stable
What does the support person do at the on-site evaluation in Iowa City?
Before a candidate can be accepted for listing for a deceased donor transplant or for a living donor transplant, the candidate and the candidate's support person must have an initial evaluation at the VA Iowa City Health Care System Medical Center. For local candidates, the on-site evaluation usually can be completed in conjunction with any of your other non-transplant appointments. All other candidates will be in Iowa City for two to four days, depending upon the candidate's dialysis schedule, flight arrangements, and the availability of our staff. At this evaluation, the support person will:
- be in attendance
- attend any other required appointments
- join you in learning about kidney transplantation
- provide emotional support to you during the workup process
- provide emotional support and encouragement to you during the waiting period if your name is placed on the national transplant waiting list
What does the support person do at the time of the transplant?
Your support person should be ready to accompany you to the Transplant Center whenever you are called to transplant surgery. While in Iowa City during the time of the transplant, your support person will:
- provide emotional support to you
- be available to assist you when needed
- attend any required appointments with you
- learn about your post-surgery medications with you
- assist you in memorizing your medications and medication schedule
- learn with you about how to keep your new kidney healthy
- assist you in learning how to prevent infections and rejection
- assist you in memorizing how to check yourself for signs of infection and rejection
- remain committed to stay with you until your transplant physicians approve your return to home
- assist you with simple patient care and medication administration
- encourage you to walk after surgery in order to avoid blood clots, pneumonia, or other problems
- provide support and encouragement to you, especially if your stay in Iowa City becomes extended due to medical complications
How long does the support person stay with me at the time of transplant?
The support person must be committed to stay with you for the entire time you are in Iowa City. This time includes the day of surgery, your in-hospital recuperation period, and your convalescent period at the nearby motel. The average length of time you will be in Iowa City at the time of your transplant generally is 3 weeks. However, if post-op complications arise, the length of stay can be considerably longer, depending upon the number and nature of your medical problem(s).
What role does the support person play in the months following my transplant surgery?
In order to have a successful transplant outcome, you must be willing to accept the support person as a part of your overall plan of care. Numerous studies have proven that patients who have good social support tend to have good transplant results. Your support person will play a vital role in helping you maintain good health. In the months and years that follow your transplant surgery, your support person will:
- encourage you to follow your medical treatment plan
- accompany you to your clinic visits
- assist you with learning any changes to your medications, as they probably will be changed several times during your first year after surgery
- encourage you to exercise regularly so you can avoid the weight gain that sometimes is associated with certain medications
- encourage you to eat a healthy diet
- offer support and encouragement, especially if your post-op course becomes difficult.
Does the VA pay for the travel expenses for the support person?
Your referring VAMC has referred you to our program, so they will pay for your support person's travel expenses, as well as your own. If your support person drives to Iowa City, he/she will be reimbursed by the referring VAMC at a rate set by the VHA. If the referring VAMC has determined that your support person should fly to Iowa City, then that VAMC will arrange and pay for the flight. The VA Iowa City Health Care System Medical Center will pay for the shuttle service between the Cedar Rapids Airport and Iowa City.
Who pays for my support person's lodging?
The VA Iowa City Health Care System Medical Center provides lodging for your support person at a nearby motel. The motel has a shuttle service that provides free transportation between the motel and the VA Iowa City Health Care System Medical Center.
Will the VA pay for my support person's meals?
The VA will NOT pay for any meals for the support person during the time of the on-site evaluation nor at the time of transplant. The support person is expected to be prepared financially to handle all his/her meals and nutritional needs. However, the motel we utilize has free continental breakfasts daily and free evening snacks on weeknights. All other meals are the responsibility of your support person.
What about other expenses?
The VA does not pay for or reimburse you or your support person for any other expenses, including child care, laundry, or lost wages.
Will we be able to cash personal checks there?
You will find it very difficult to cash personal checks in Iowa City. Even banks will refuse to honor out-of-state checks. Traveler's checks may be your best option, because they can be cashed easily nearly anywhere and are much safer than cash. In addition, the VA Iowa City Health Care System Medical Center has an ATM that accepts Shazam, MasterCard, VISA, American Express, Plus, and Cirrus.
Can other family members come with me at the time of my transplant?
Strong family support can be quite helpful to patients. However, the VA provides transportation and lodging only for the patient and one support person. If you choose to have additional support persons, they must travel and lodge at their own expense.
Can my family members stay in my hospital room with me at the time of my transplant?
No. Visiting hours are 10:00 a.m. until 8:00 p.m.
Can my children come to Iowa City with me?
Because the hospital offers no activities to keep young children entertained, most veterans arrange for their children to stay at home with other family members.
Who can answer my other questions regarding my support person?
Contact our Transplant Social Worker at 319-338-0581, extension 6596, for further information or assistance.
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The person you choose to be your support person will play a vital role in your transplant success, as well as in your overall post-surgery plan of care. Your support person will help you through your transplant workup, your surgery, your recuperation period, and in the months and years following your transplant. Your support person will provide the assistance and encouragement needed to enhance your coping abilities and to help ensure your comfort and safety. After your transplant, your support person will help you adhere to your medical treatment plan, assist you with your medications, and accompany you to your medical appointments. Your support person and your VA transplant team will be dedicated to your good health and to your transplant success.
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