Home Based Care and Its 4 Components.
What is home based care?
Basically, this is the care of a patient infected and affected of HIV/AIDS that is extended from the hospital or health facility to the patient’s home through family participation and community support.
As a healthcare strategy, home based care has been effective in increasing quality of life. In addition, hospital staying as a result of HIV/AIDS is rare due to this type of management and others such as use of HAART.
However, research has shown that patients receiving home based care show improvement in ART adherence. Moreover, their viral load is mostly at low detectable levels thereby, boosting their health thus paving way to family functions.
The home based care providers follow these components to ensure optimal patient safety. They therefore, include:-
a.) Clinical care
b.) Nursing care
c.) Counseling and psycho-spiritual care
d.) Social support
1.) Clinical Management
- Early (home care) diagnosis
- Rational treatment and planning for follow up.
- Care of HIV-related illness.
2.) Nursing Care
3.) Counseling and Psycho-spiritual home care.
- Reducing stress and anxiety.
- Promoting positive living and helping individual to make informed decision on HIV testing.
- Planning for the future and behaviour change and involve sexual partner or patient in such decisions.
4.) Social support
- Information and referral and forming support groups.
- Welfare services and legal advice for individuals, families including surviving family members where reasonable with provision for maternal assistance.
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Reasons for Home Based Care
- To prevent problems where possible.
- Take care of existing problems.
- It also enables people to know when to get health.
Advantages of Home Based Care
- It permits them to receive care in a familiar, supportive environment.
- Helps them stay healthy longer.
- It uplifts PLWHA to proceed in home/family matters.
- It maintains sense of belonging to social groups.
- Makes it easy for them to accept their condition.
- HBC minimizes the emotional health.
- HBC calls the family together.
- It helps the family accept PLWHA.
- Makes it easier to provide care and support.
- Home based care can reduce medical costs.
- It makes it easier for family members who provide care to PLWHA to attend to other responsibilities.
- It promotes awareness about prevention of HIV/AIDS.
- Helps the community understand the disease and counteract myths and misconceptions.
- Home based care can reduce costs.
- Encourages the sustainability of the care services.
- It makes it easier to provide support.
- It can help the community to maintain cohesiveness (togetherness).
Firstly, it does not require creation of extra services where resources are already inadequate.
Secondly, home based care eases demand on health system.
Finally, it extends the responsibility to family and community.
Observe the Following During Home Based Care.
Observation is a skill all health workers and caregivers need to master.
PLWHA or any other patient may react or get to a level where other underlying issues/signs of illness cause them to feel uneasy.
You have to take note of such signals during home based care. Here is what you should check on as a health provider:
Things to Observe on Your Patient.
i.) Power of Observation
Actually, caregivers can prevent a lot of problems by being aware of some danger signs of illness.
As you bath the patient or perform other home based care services, be aware of the following :-
- Mood– If he’s alert, sleepy, irritable, jumpy or withdrawn.
- Colour– Normal, yellowish, nails (bluish signaling no oxygen)
- Skin– Rashes, dry ulcers, blisters, sweaty or loose, clumpy (signs of shock).
- Body-Feverish cold, sweating.
- Breathing– Fast, slow, rough, wheezy.
Other things to watch also include :- Heartbeat- pulse.
As a health worker, it is very important to know what is normal and what is not.
ii.) Nail care
A person’s hands can’t be clean until the nails are clean as well.
Keeping fingernails and tore nails neatly trimmed and clean should be the person’s part of everyday hygiene.
The caregiver can help if the person is not able to do it alone.
Objectives- To keep the nails clean in order to :-
- Reduce collection of germs.
- Prevent self-injury.
- Raise the patient’s morale.
iii.) Washing hair in bed
Like bathing, a person doesn’t stop the need of clean hair just because they can’t get out of bed.
Using precautions as those of bed bath, the home based care giver can wash the patient’s hair right in bed. This contributes to the person’s hygiene and wellbeing.
The objective is to maintain personal hygiene in order to keep the PLWHA healthy and maintain a well-being.
iv.) Turning the patient in bed
People sometimes become so ill they can’t also move themselves in bed. If this happens, the person is likely to develop pressure sores which are caused by the skin breakdown because of constant pressure.
Pressure sores may form on bony parts of the body for example; elbows, buttocks, back, hips, feet and ankles. To prevent this during your home based care, turn your patient (PLWHA) every 2 hours.
The main reason is to prevent the patient from developing pressure sores as a result of lying in the same position for so long.
Mmaka Abbas. (2020). Jamii-Health Blogger & Community Health Officer/Health Counselor. Mombasa County. Kenya. https://jamii-health.co.ke/