Community owned programs in palliative care

1. Community owned programs in palliative care Dr Suresh Kumar

2. COPP - Rationale • Patients with advanced diseases require continuous care and attention for the rest of their lives • They are also in need of regular social, psychological and spiritual support in addition to the medical and nursing care • Care should be readily accessible and available as close to home as possible • There is enough potential available in the community to build a ‘safety net' around these patients

3. Palliative Care in the Community

4. Care in the community by volunteers The Foundation: Establishing a social support system • Food for patients • Transport • education support for children Adding on local expertise: • Emotional support • Basic nursing chores • Help with mobility

5. Primary Health Care Capacity building at the primary health care level • Training • Drugs and equipment Integration between the primary health care and community owned services

6. Interface between ‘specialists’ and the periphery Trained Health Care Professionals as the link • Professionals employed by community based organizations • Professionals working in primary health care facilities in the region • Professionals employed by the ‘specialist institution’

7. Community Volunteers Sensitization for ‘level I’ Training for ‘level II’ Basic Principles of PC Psycho social assessment of patients Communication skills/ emotional support Basic Nursing chores Documentation

8. Professional support for community owned services • Physician • Palliative care nurse • Auxiliary Nurse in PC

9. The matrix of community owned palliative care program One can start with any component and build the others

10. COPP – Practice

11. Neighborhood Network in Palliative Care • Looks after more than 10,000 patients at any point of time- all the services are free • All the expenses for delivery of care (including salaries, cost of medicines, food for the family, educational support for the children) raised locally

12. NNPC - structure • Network of trained volunteers in the community • Support system by trained professionals, institutions and organizations • Palliative care institutions as nodal centers

13. Volunteers • Anyone who wants to contribute in the efforts to reduce the suffering of people living with advanced diseases • Structured training given to those who are willing to spend at least two hours per week for the work

14. Training • Training as part of generation and dissemination of knowledge • 16 hours of theory • 4 days of practical work

15. What do volunteers do? • Regular continuous emotional support for the patients and family • Social support to the patients • Wound care, bedsore prevention, mobility • Spread the idea of palliative care in the society • Fight social stigma to cancer, AIDS etc. • Organisation & administration of palliative care services

16. Community Participation in Palliative Care – Palliative Care is everybody’s business • More than 12,000 community volunteers from various walks of life • Majority belong to lower socio economic strata • Majority are young people

17. Palliative care in campus

18. Palliative Care is everybody’s business – Police in Palliative Care • Kerala Armed Police Battalion IV runs its own palliative care unit – Probably the first of its kind in the whole world! • City Police in Calicut a major partner in palliative care in the city

19. Emerging Kerala Model in Palliative Care • Public health approach in palliative care • Community participation as a core principle • Need based evolution • State owning up responsibility. Planned activities in Government sector

20. Thank You!drsuresh.kumar@gmail.com