A separate dialysis unit was created within an existing large dialysis unit for the purpose of segregating all new hemodialysis patients into an environment that would provide optimum instruction about self-care. An educational curriculum was presented to each patient during each dialysis over the first 2 months of dialysis. Depending upon medical condition and response to the curriculum, patients were transferred either to the home hemodialysis training unit with or without a helper, to the limited care facility, or to the general dialysis area for medically unstable patients. An orientation unit not only improves patient participation in self-care, but appears to increase the number of patients interested in dialyzing at home.