scholarly journals ‘Battling on’ and ‘blinkered’: carer experiences of home based care at the end of life

2012 ◽  
Vol 2 (2) ◽  
pp. 5.3-5
Author(s):  
E. Harrop ◽  
A. Byrne ◽  
A. Nelson
Keyword(s):  
End Of Life ◽  
Home Based ◽  
Home Based Care

scholarly journals Home-Based Care Practitioners: A Strategy for Continuum of Care for Very Ill Patient

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 121s-121s
Author(s):  
D. Mukasahaha ◽  
F. Uwinkindi ◽  
L. Grant ◽  
J. Downing ◽  
J. Turyahikayo ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Quality Care ◽  
Economic Cost ◽  
Supervisory Relationship ◽  
Home Based ◽  
Implementation Period ◽  
Hospital To Home ◽  
Home Based Care

Background: Rwanda Ministry of Health in collaboration with partners has initiated an innovative initiative named Home Based Care Practitioners (HBCPs) to respond to the burden of long-term hospitalization for end of life patients. Aim: The program aims at providing home-based care to accompany patients and their families in their home, reduce unnecessary pain and suffering for those with chronic or terminal conditions, provide counseling to the patients and their families, early diagnosis of NCDs and improve awareness on prevention of NCDs risk factors and effectively refer them to either health facilities or community-based resources that can be of further help. Methods: The HBCPs is implemented into phases; phase one has started with a pilot of 200 HBCPs in 100 cells surrounding nine provincial and referral hospitals of Rwanda; 2 practitioners for both gender in each cell, with a criteria of completion at least secondary school. They have undergone a training of 120 credits (900 hours), equivalent of four months for theory and two months of practice. After training they have been deployed into the community with a supervision of health centers in collaboration with hospitals and Rwanda Biomedical Center. Results: During the implementation period of 6 months, 1663 NCDs patients have been transferred from health facility (OPD) to HBCPs for routine follow-up, 482 palliative care patients have been reported on end of life care by HBCPs, there is a remarkable linkage between facilities and community care ensured by supervisory relationship between health services providers and home based care practitioners, long-term admission has reduced the cost for the family and the facility due to the discharge of care from hospital to home. Conclusion: In a limited setting of social and economic cost of providing frivolous care in an expensive hospital for chronic or terminal conditions that would be better managed through treatment or palliative care at home (or less acute setting) home based care effort can better meet the needs of Rwandans at the community level and has started to show the efficiency in providing quality care to people in need of palliative care.

scholarly journals From end of life to chronic care: the provision of community home-based care for HIV and the adaptation to new health care demands in Zambia

2016 ◽  
Vol 17 (06) ◽  
pp. 599-610
Author(s):  
Carolien J. Aantjes ◽  
Joseph Simbaya ◽  
Tim K.C. Quinlan ◽  
Joske F.G. Bunders
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
End Of Life ◽  
Chronic Care ◽  
Hiv And Aids ◽  
Structured Interviews ◽  
Primary Health ◽  
Home Based ◽  
Home Based Care ◽  
Care Demands

AimWe present the evolution of primary-level HIV and AIDS services, shifting from end of life to chronic care, and draw attention to the opportunities and threats for the future of Zambia’s nascent chronic care system.BackgroundAlthough African governments struggled to provide primary health care services in the context of a global economic crisis, civil society organisations (CSO) started mobilising settlement residents to respond to another crisis: the HIV and AIDS pandemic. These initiatives actively engaged patients, families and settlement residents to provide home-based care to HIV-infected patients. After 30 years, CHBC programmes continue to be appropriate in the context of changing health care needs in the population.MethodsThe study took place in 2011 and 2012 and was part of a multi-country study. It used a mixed method approach involving semi-structured interviews, focus group discussions, structured interviews, service observations and a questionnaire survey.FindingsOur research revealed long-standing presence of extensive mutual support amongst residents in many settlements, the invocation of cultural values that emphasise social relationships and organisation of people by CSO in care and support programmes. This laid the foundation for a locally conceived model of chronic care capable of addressing the new care demands arising from the country’s changing burden of disease. However, this capacity has come under threat as the reduction in donor funding to community home-based care programmes and donor and government interventions, which have changed the nature of these programmes in the country. Zambia’s health system risks losing valuable capacity for fulfilling its vision ‘to bring health care as close to the family as possible’ if government strategies do not acknowledge the need for transformational approaches to community participation and continuation of the brokering role by CSO in primary health care.

Prepared to care: managing home based care and the information needs of carers at end of life

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A40.2-A40
Author(s):  
Emily Harrop ◽  
Annmarie Nelson ◽  
Anthony Byrne
Keyword(s):  
End Of Life ◽  
Information Needs ◽  
Home Based ◽  
Home Based Care

Telemedicine in Cancer Care

2018 ◽  
pp. 540-545 ◽  
Author(s):  
S. Joseph Sirintrapun ◽  
Ana Maria Lopez
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Symptom Management ◽  
Lifestyle Modification ◽  
Clinical Settings ◽  
Home Based ◽  
Home Based Care ◽  
Care Costs ◽  
Improve Access

Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient’s electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.

scholarly journals Dying at home of Covid-19: Meeting the need for home-based care

2020 ◽  
pp. 106409
Author(s):  
Cara Kiernan Fallon ◽  
Madison K. Kilbride
Keyword(s):  
Home Based ◽  
Dying At Home ◽  
Home Based Care ◽  
At Home
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