Home Based Care

Abstract

Home-based care is already expanding rapidly in all countries. This expansion is due in part to increasing need but also, in developed countries, to a shift from hospital-based care to home and community care for economic reasons. In addition, public health services, and especially hospital services, in developing countries are of poor quality, primarily because of diminishing resources, and most of the population cannot afford private health care. Cost considerations thus tend to shift the burden of both acute and long-term care to the family. In the very poor countries, health centres are overwhelmed, staff are not paid for months, drugs and equipment are often unavailable, patients' expectations of service quality are not met, etc. Most common ailments are therefore treated in the home and most people die at home. ^1,2,3

In all countries, families have always been, and remain, the major providers of longterm care. This is true for the care both of elderly people and of people with chronic conditions such as HIV/AIDS, tuberculosis, and malaria. However, families cannot shoulder the increasingly heavy burden of care alone. Because of a wide range of social, economic, demographic, and epidemiological factors (e.g. migration, changing rural and urban social environments, poverty, ageing, or health problems affecting family members themselves), family resources are decreasing. These developments require the adoption of a very different approach to health sector policy and health care services: a disease-specific approach alone is no longer appropriate. The one common result of the worldwide demographic and epidemiological changes mentioned above is growing functional dependence, with a concomitant increase in the need for assistance in managing everyday living. ^1,2

Home Based Care draws on the strengths of families and communities. Its goal is to provide hope through good-quality and appropriate care that helps patients and families maintain their livelihoods and the best possible quality of life .Most people like to be cared for at home. Effective home care improves the quality of life of chronically ill people and their family caregivers³.