The document discusses comprehensive care for patients with HIV/AIDS, which should address physical, social, psychological/emotional, and spiritual needs. It emphasizes treating the whole person by considering their relationships and involving family/friends on a multi-disciplinary care team. The team should provide medical care, counseling, social support, rehabilitation, palliative care, and involve community services and support groups.

1. MODULE 5 Comprehensive HIV/AIDS Care Unit 1: The concept of comprehensive care

2. SPIRITUAL THE PERSON EMOTIONAL PHYSICAL SOCIAL Holistic care

3. Comprehensive Care Concept Consider the patient with HIV/AIDS as the centre Plot around him the needs he has Now plot around him the people to whom he relates in his normal life

4. Everyone needs To feel loved and valued To be able to trust To have honest communication To have hopes and goals To express his personality To have dignity To be given respect and choice To have peace of mind To have physical care and comfort

5. The person who is ill relates to Spouse caregiver Siblings, parents Colleagues peers Children Close friends church Nurse at work Hospital doctors, nurses, team Community health worker Other PLWHA’s Extended family

6. Services to be offered in CCC Brainstorming for 5 minutes

7. The comprehensive care team managing the patient Spouse/partner Other family and friends Community services Spiritual Care givers Occupational therapist Physiotherapist Doctors Nurses Counsellor Nutritionist

8. Group discussion 10 minutes Discuss and define the importance of the following in HIV/AIDS care: Physical care Social Care Psychological/emotional care Spiritual care

9. Physical Care Medical and nursing – treatment of illnesses and symptoms; lab and pharmacy support Physiotherapy – strengthening muscles and bone after illness and weight loss Nutritional advice Occupational therapy – to re-teach activities of daily living; teach new skills for income generation

10. Clinical care Opportunistic infections STI treatment Lab indicators of progression of disease TB treatment and follow-up ARV prescription Palliative care

11. Psychological/emotional care The whole team – attitudes, how you greet patients, skills, knowledge, motivation and compassion Counselling Volunteers Community health workers – home support

12. Social support Community support – NGO’s, church Private sector, individuals, organization Examples include post test clubs for positive clients, clubs for adolescents and youth Day care for children/adults where they can play games, share information etc

13. HOME BASED CARE Identify family care givers Encourage them to accompany the clients in every visit Educate them on patients condition and basic home based care in the following Clinical care at home, nursing and psychological care, social and spiritual support

14. HOME BASED CARE (CTD) Education and demonstration for patients and FCG on care Education on adherence, psychological support nutrition Involve the local community health workers to provide support and follow-up through DOTS Refer to community comprehensive care clinics for continuum of care

15. Post test club (support groups) A place to promote AIDS awareness A place to promote and maintain behavior change A place where members share their experiences and learn from one another A place to promote any useful activity e.g income generating activity

16. Referral and networking DIRECTORY NETWORKING FORUM PARTNERS

17. Rehabilitation The restoration of normal physical, emotional, social and spiritual function to the individual within the context of the natural progression of the disease This applies in children too, and includes restoration of ability to play, laugh, eat, pray, sing and to feel loved and secure

18. Rehabilitation

19. Inter-agency team work VCT Hosp Clinic CBO NGO Church Networking Referrals

20. Spiritual Care Care which relates to the spirit or soul of a person and facilitates its expression Spiritual means that within a person that relates to, or reaches out to, God, to the Creator, or to ‘something or someone greater’ It also relates to values such as love, beauty, joy, honesty, integrity, absolute standards of right and wrong, forgiveness

21. A saying ‘ Do not walk ahead of me, I may not follow; Do not walk behind me , I may not lead; Walk beside me and be my friend’

22. Palliative Care definition (WHO 2002) PC is an approach to care that aims to improve the quality of life of patients and their families who are facing …life-threatening illness It prevents and relieves suffering by means of early identification, impeccable assessment, and treatment of pain, and other problems – physical,psychosocial and spiritual Internet source to be availed Dr Margaret Makanyengo AMREF presentation

23. Palliative Care (WHO 2002) An approach which affirms life, but regards death as a normal process It intends neither to hasten or postpone death, but aims to improve the quality of the life that is left to the person Using a team approach, it offers a support system to help patients live as actively as possible until death

24. Palliative Care (WHO 2002 cont) It treats pain and other distressing symptoms Because it enhances quality of life, it may even prolong it, ‘giving life to days and days to life’ Applies early in the course of the illness with other therapies intended to prolong life……. Offers support to help the family cope during the patient’s illness and after his death – bereavement counselling and support

25. Post test club or support groups A place where people meet A place where people have tested positive or negative A place where those considering testing come to A social club where people who are HIV negative interact with and support HIV+