HIV Home based care

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HIV/AIDSHome based care : 

HIV/AIDSHome based care Daisy Dharmaraj TEST Foundation/ ACS

Home based care : 

Home based care “Any form of care given to sick people in their own homes by their families or other care providers”. It includes physical and psycho-social support.

The Continuum of Care Model : 

The Continuum of Care Model

Who among PLHIV needs hospital care? : 

Who among PLHIV needs hospital care? Very sick person Those Developing reactions to drugs Pregnant woman during delivery Surgical emergencies

Who needs Home based care? : 

Who needs Home based care? Any PLHA who needs special support Those on treatment and have to be monitored Vulnerable women and children in special circumstances children who are infected Terminally ill person

How is Home based care better than hospitalisation…. : 

How is Home based care better than hospitalisation…. Stigma and discrimination in hospitals Infrastructure of hospitals insufficient Patients may pick up infections from prolonged hospital stay Hospitals cover only clinical needs, not emotional and social needs.

Slide 7: 

Home care is cost-effective. Familiar surroundings. Therefore more acceptable Family routine is not disrupted by hospital visits. Offers scope for de-stigmatisation by education of the family and community. Helps to train others to care for the PLHA

It should be a Comprehensive care which includes : 

It should be a Comprehensive care which includes Clinical management Nursing Care Psychological support Social support Others Some of these are for both for the PLHA and the family

Slide 9: 

Clinical management - diagnosis - rational treatment Nursing care - hygiene and nutrition - palliative care - educate patients and family on prevention of transmission Let us look at each component….

Slide 10: 

Psychosocial support Pre- and post-test counselling Promoting positive living Planning for the future Behavioural change

Slide 11: 

Social support Referral to support groups Welfare services Legal advice Livelihood options Material assistance

Needs to be addressed : 

Needs to be addressed Health needs Nutrition needs Social needs Emotional needs Day-to-day needs Financial needs Spiritual needs

Slide 13: 

Health needs: Providing health workers, medicines, medical treatment, follow-up, referral and personal hygiene. Nutrition needs: Educating about affordable nutritious food and safe drinking water Social needs: Reducing stigma and fear in family & community

Slide 14: 

Financial needs Planning income and savings, property matters, insurance and claims Spiritual needs Coming to terms with guilt and disease, Encouraging supportive environment in religious communities

Slide 15: 

Emotional needs Ensuring supportive home environment, support groups, fight stigma Day-to-day needs Personal care. Taking medicines, Help with household chores, child care, shopping, tending livestock

Examples of Health Education : 

Examples of Health Education Nutrition and feeding Use bleaching powder to clean defecation or blood of patient Turning bedridden patients every few hours to prevent wounds Help PLHAs with possible depression, anxiety etc. Traditional medicines and plants to relieve skin infections,piles and other minor illness. Safer sex .Water and sanitation

Stigma and Discrimination : 

Stigma and Discrimination Stigma is a hurdle for home-based care Rejection by families AND community PLHAs seen as ‘bad’ people/ Fear of death Ignorance about modes of transmission Counselling can be a solution Role modelling by accepting them and treating them as one of us helps a lot!

Constraints : 

Constraints Confidentiality within family Possible discrimination by community Undue expectations from PLHA and family PLHA too sick and needs hospital services Inadequately trained staff Easier in places of high prevalence…

Qualities of providers of Home based care : 

Qualities of providers of Home based care Interest and empathy Ability to understand and respond to mental, emotional and physical status of PLHAs Counselling skills Outgoing personality Good communication and networking skills

Task made easier : 

Task made easier By training a family member to care for the infected person Motivating local health care providers towards support and care Providing emergency medicines like ORS Providing information of institutions whom they could approach in emergencies….

Slide 21: 

THANK YOU. Let us get going!!

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