COMMUNITY LEVEL HOME-BASED CARE

1. Every community provides some home-based care and has access to community-based care through partnership of community-based and clinic-based health services.

2. All clinics serving communities in their catchment areas identify home-based carer co-ordinators for formal and informal sector activities.

3. All communities with home-based care have access to a referral system and to comprehensive support services.

4. All clinics have access to home-based care guidelines and palliative care guidelines so that they can assist communities and families.

1. Home-based care is comprehensive and holistic, person centered, sensitive to culture, religion, values and respects privacy and dignity and maintains self-esteem.

2. It empowers and promotes functional independence of the individual and family.

3. The patient, the carer and the community are provided with appropriate targeted education.

4. Home-based care assists in reducing unnecessary visits and admissions to health facilities.

5. Community groups and individual home-based carers receive training from the nearest competent resource – NGOs or the local clinics or visiting health team.

6. Community groups and clinics maintain records of home-care and it’s continuity and consistency.

7. Patients referred from a health facility for home care have the homestead carer prepared and given adequate instruction on medication and daily living care. Referring facilities also provide prescribed medicine and assistive devises.

8. Protocols or manuals of care are provided to home-care patients from the local clinic on palliative care and the management of pain.

9. Community-based training of home-carers is based on adult education principles and practical simple guidelines.

10. Health staff assist in the development of case management plans which consider physical and psychological needs, environment social networks, diet, exercise and rest, personal habits, sexuality, recreation, dressing, washing, feeds, toilet, continence, hearing, seeing and home layout.

11. Community groups, family, neighbours or volunteers assist with continuing home needs.

12. Social workers assist with arranging legal assistance (e.g. wills) and application for disability grants and other social support.

13. Integrated community home-based services have a mosaic of categories, (medical, counselling, pastoral, rehabilitation and traditional) brought together around the individual and family through professional co-ordination.

14. Home care for AIDS in the community includes access to common drugs, emotional support, consideration of families, help with households, kind relationships from clinic staff and financial support if available through social welfare or self-help groups.

15. The community care of AIDS patients involves a continuum of care, which links all available resources in a community.

16. The continuum of care starts from initial counselling to include care of psychosocial needs, medical and nursing needs and family needs such as care of children, legal advice and assistance.

17. Clinics, hospices, NGOs and community groups are linked in a network and this can be initiated by the clinic, NGOs or community groups.

18. The aims of AIDS home care are the same as for any home-based health care programme:

18.1 to prevent problems when possible
18.2 to take care of existing problems
18.3 to know when and how to get help.