Aasai

Palliative care plan as per the immediate needs of community.

1.INTRODUCTION.

According to palliative care handbook, palliative care means a medical approach which improves the quality of life of patients and families facing life threatening illnesses through prevention and relief of suffering by means of early identification and offering social, cultural and psychological support.Palliative care can be offered in the course of other treatments for example Antiretroviral therapy, Chemotherapy and radiotherapy.The fact that it can be offered in the course of other treatments differentiates palliative care and hospice care.

In hospice care,no other treatments can be involved and only patients nearing death in less than six months are the ones offered hospice care.Palliative care can be offered in various settings such as hospital based care,home based care and day care based.Most of the African communities prefer hospital based palliative care because it offers a holistic health care approach and patient centered care.

In addition to that, another pros for increased preference for hospital based care is because it involves a variety of qualified and trained professionals including doctors, nurses, psychologists, counsellors, social workers and chaplains.All the above mentioned professionals have a clearly defined jobs and have to adhere to the code of conduct that is respect the patient, integrity and competence care.Palliative care  covers various topics including palliative care in children, bereavement, death and dying, management of palliative care emergencies and self care practices.

There is a need for palliative care centers in the LUO COMMUNITY   since majority who suffer from terminal illness moreso HIV AND AIDS and cancer fail to get appropriate care during illness thus leading to mental health issues like stress and depression.Furthermore,there is need to raise awareness inorder to prevent cases of stigmatisation and myths sorrounding terminal illness and palliative care.Thus,the need to come up with the above proposal.

2.LITERATURE REVIEW.

Palliative care refers to medical approach which improves quality of life of patients and families suffering from life threatening illnesses through symptom management,pain management and offering social, emotional, spiritual and psychological support.Palliative care began in 20th century by Saunders who later worked at St Christophers Hospice center in London.He developed palliative care with the aim of assisting patients facing life threatening illnesses relief from symptoms associated with stress and depression.She developed various models of care in palliative care.

Models of palliative care.

1.Home based.

2.Facility based care.

3.Roadside clinics.

4.Inpatient care.

5.Outpatient care.

According to the study by Smith et al (2019),he highlights increasing prevalence of terminal illnesses such as cancer and heart diseases necessitating comprehensive care services to meet the growing demand for palliative care.Study done in 2008 concluded that patients suffering from HIV AND AIDS were 22 million people in Africa with 1.9 million patients getting infected that year.A study done in 2007 shows that estimated 7.6 million were cancer patients with 6 million infected that year.

This is according to palliative care handbook.This increased number was due to lack of awareness in the case of HIV AND AIDS and bad lifestyle habits like high consumptions of fatty foods and lack of exercise.According to a study by Mc Corkle et al (2017), family members of patients receiving care reported reduced anxiety and improved coping strategies for example problem focused coping and emotion focused coping thus the importance of appropriate palliative care system.Palliative care is a multidisciplinary discipline comprised with multidisciplinary team.

Multidisciplinary team in palliative care.

1.Nurses

2.Doctors

3.Social workers

4.Community health promoters

5.Chaplains

6.Psychologists and counsellors

Psychologists and counsellors serve  very fundamental roles in palliative care.

Roles of psychologists and counsellors in palliative care setting.

1.Provide psychological support for example relief from psychological distress.

2.Counselling the patients with the aim of ensuring that they adhere to treatment despite challenges.

3.Advocating for the rights of patients with terminal illnesses by use of various palliative care handbooks for guidance and support.

4.Involving families of terminally ill patients in appropriate ways.

5.A center of open communication between terminally ill patients and their families.

Elizabeth Kubler Ross worked with cancer patients and mentioned five stages of grief for terminally ill patients including denial,anger, bargaining, depression and acceptance.

3.FINDINGS.

INCREASED NUMBER OF TERMINAL ILLNESSES .

There has been increase in terminal illnesses because of unhealthy behaviours like engaging in unprotected sex,wife inheritance and various myths for HIV AND AIDS to be specific.According to palliative care handbook,22 million patients had HIV in 2008 with 1.9 infected that year.According to ministry of health report,Nyanza province and Nairobi province continue to take the lead in the number of cases of HIV AND AIDS.

MYTHS AND MISCONCEPTIONS ABOUT TERMINAL ILLNESSES HINDERING TREATMENT ADHERENCE.

Healing by use of herbs and healing through prayers have served as the two great myths sorrounding terminal illnesses.

LACK OF AWARENESS LEADING TO CONTINUED SPREAD OF TERMINAL ILLNESSES.

There has been lack of education awareness on primordial preventions methods like adopting healthy lifestyle, substance abuse prevention and policy development on proper disposal of industrial wastes.

4.RECOMMENDATIONS AND SUGGESTIONS.

1.Seek medical assistance and counseling-There is need for terminally ill patients to seek medications accompanied by counselling to help relief from physical and psychological symptoms.

2.Enacting policies-Will be aimed to curb"sex for fish", improper disposal of industrial wastes and wife inheritance.These are major contributions to illnesses.

3.Education awareness-Target audience being the youths from lake regions on various modes of prevention as well as retired adults suffering from terminal illnesses on the importance of seeking counselling.

4.Construction of palliative care centers-County government support is needed to ensure construction of palliative care centers.

5.BUDGET.

The estimated budget is to run for the year 2024-2025.

Figure 1: Personnel, Number of personnel and cost per month.

Doctors

2

70,000

Nurses

10

60,000

Psychologists

10

50,000

Social workers

5

40,000

Chaplains

2

40,000

Accountant

1

50,000

Palliative care centre manager

1

100,000

Figure 2: Resources needed, number and costs.

Resources

Number

Costs.

Land

2 hactares

1.5 million.

Building materials

Enough

1.5 million.

Licensing

1 year license

10,000.

The total estimated budget is Ksh 3,010,000 for resources and Ksh 1,670,000 for personnels every month for a period of one year.

6.STAKEHOLDERS.

1.Ministry of health, county governments.

2.Proffesionals like doctors and psychologists.

3.The Media for advertisement and awareness.

4.The community.

5.Non-governmental organisations.

6.Donors.

References.

1.Palliative care handbook.

2.Smith,E.A.(2019).Prevalence of terminal illness.Harvard publishers.

3.Corkle,M.C. (2017). Coping strategies.Oxford publishers.