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
Some of these are for both for the PLHA and the family Slide 9: Clinical management
- rational treatment
- 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
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.
Educating about affordable nutritious food and safe drinking water
Reducing stigma and fear in family & community Slide 14: Financial needs
Planning income and savings, property matters, insurance and claims
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
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
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!!