Community owned programs in palliative care

Dr Suresh Kumar

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

Palliative Care in the Community

Care in the community by volunteers

The Foundation: Establishing a social support system

• Food for patients• Transport• education support for childrenAdding on local expertise:• Emotional support• Basic nursing chores• Help with mobility

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

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’

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

Professional support for community owned services

1. Physician2. Palliative care nurse3. Auxiliary Nurse in PC

The matrix of community owned palliative care program

One can start with any component

and build the others

COPP – Practice

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

NNPC - structure

• Network of trained volunteers in the community

• Support system by trained professionals, institutions and organizations

• Palliative care institutions as nodal centers

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

Training

• Training as part of generation and dissemination of knowledge

• 16 hours of theory • 4 days of practical work

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

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

Palliative care in campus

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

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

Thank You!drsuresh.kumar@gmail.com