Community Based Home Care

So Yana and I have been working in Mmopane (a nearby village) to make home care visits with the community health volunteers. The volunteers explained that home visits involve going into homes and consulting with the family to assess the patient’s needs. First they start by greeting and praying with the patient. Then the volunteers will ask the family if the patient has eaten. If water is needed, they will fetch it. If food is needed, they will go and buy food to cook for the patient. They will also do physical labor that the patient cannot such as cleaning the yard and making sure the patient’s home environment is in order. The volunteers and the nurses play a pivotal role in this community. If there is no caregiver in the family, the volunteers and nurses become the primary caregivers. This care concept is almost unheard of in the United States; the selfless, compassionate nature of these volunteer caregivers is insurmountable. Due to the work of these caregivers, the acuity of the patients has significantly decreased making it easier for the caregivers to provide care and see outcomes. These volunteers earn a meager 100 pula/month (about 16 US dollars). Some of this money may even be used to buy food for the most impoverished of families. Needless to say, we have come to find that those who have the least give the most.

Since Yana and I are making home visits with the volunteers, they've somewhat modified their approach. Our visits are more focused on disease-related issues rather than the ADL-focused care that volunteers provide. It has been a very humbling experience and what is more astonishing to me is that the volunteers and patients have trusted us to provide care. I have never been in a patient care situation where I was the sole provider. So home visits involve assessment, diagnosis, and treatment! This concept is fairly new to many of us because in our undergraduate nursing education, we're not necessarily responsible for dx and tx (obviously, this is more in the NP or doctor realm of practice). Nonetheless, it has been a very challenging and interesting experience.