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Community Based Palliative care

Chronically ill people like patients with advanced cancer spend most of their time at home and are in need of regular care for the rest of their lives. The concept of 'total care' with continuous support in physical, psychosocial, and spiritual realms into practice through institutionalized care is very difficult. It offers a patchy service through which the patient and family has access to care for a few hours. The community approach is the only realistic model for achieving significant coverage and continuity of services for terminally ill.

Rationale for a Community approach to Palliative Care Service:

  • 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

The major components of a community owned /based palliative care system are

  • community volunteers and
  • health care professionals

The society initiated a community based palliative care program in collaboration with MV Foundation in May 2008. The MNJ IO and RCC is acting as the resource center for clinical service and training.
The activites so far is as listed below:

  • Several initial meeting and planning for the project
  • Development  of a need assessment survey questionnaire and validation by translation to Telugu and cross translation to English
  • A sensitization program on palliative care for 20 Volunteers from MV Foundation
  • A house to house need assessment survey of chronically ill people living in society was done in DAMERAGIDDA village of MANDAL CHEVELLA, Rangareddy District. It showed that approximately 9% of population (129 out of 1000 population) would be benefited by some form of palliative care and chronic pain services. The survey also revealed the complexity of the psychosocial issues existing within our society related to chronic illnesses.
  • Meeting with representatives of the village to discuss the results of the survey and planning. The same day a meeting was also held with doctors and nurses of Community Health Center of Chevalla.
  • Five volunteers from the village were identified and visited the MNJ Palliative care center for an orientation course.
  • A palliative care camp was held in the village for the 120 patients identified in the survey. There were several many fresh ‘walk-in’ mostly having chronic pain. Five Doctors (including one from the Community Health Center), three nurses, two social workers, five trained volunteers and a huge team of untrained but sensitized volunteers from the village participated in the camp.
  • A committee of interested volunteers was formed in the village.
  • Development of Trainers in Palliative care: Two Volunteers from MV Foundation underwent training in palliative care for one month in  Septmember 2008  at MNJ IO and RCC.
  • A Meeting was held in the village to discuss various issues.  People who attended the meeting included the village Sarpanch, Deputy Sarpanch, MVF volunteers, village youth volunteers and senior villagers.
  • Training of Community Volunteers in Palliative care.

A first batch of community volunteers from the Dameragidda underwent two days intensive training in paliaitve care.

  • A Two days volunteers training program was conducted for 21 volunteers of MV foundation working in Chevalla Mandal.
  • Regular visits by a group of doctors, nurse and volunteers to offer palliative care services to patient identified in Damergida in support with local volunteers.
  • Growing by the popular demand, the decision was taken to extend the service to neighbouring villages. A need assessment survey was done in a village called Kanapur of 1450 population. A meeting was held with people in the village in the presence of sarpanch. An action plan is being charted out to see those short listed patients and also to form a palliative care committee of interested volunteers in the village.

Survey in Kanapur by the volunteers


Meeting with Village volunteers in Damergidda

     
 
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