lO M oARcPSD| 26582732
HOME Based
CARE(1)-2
QUESTIONS WITH
ANSWERS [2024-
2025]
Medical/Surgical Nursing II (University of Nairobi)
HOME-BASED CARE
CONCEPTS, PRINCIPLES AND COMPONENTS OF HOME-BASED CARE
In the last two decades, there have been dramatic changes in the health needs of our
populations due to the rise in non-communicable diseases, terminal illnesses, injuries
1
Dow nloaded by NELSON KIIRU
()
, lO M oARcPSD| 26582732
leading to disability, and HIV/AIDS. These changes have led to an increase in the need
for long-term care and the need for care to manage everyday living. To meet this
challenge, the ministry of health has had to adopt a different approach to health sector
policy and health care services including Home-based care approach.
The Concept of Home-Based Care
Home-based care is the care of persons with chronic or terminal illnesses extended
from the hospital or health facility to the patients’ homes through family participation and
community involvement within available resources and in collaboration with health care
workers.
It is a holistic and comprehensive care which relies on collaboration between the
hospital, the family of the client, and the community, in order to enhance the quality of
life of the patients and their families. The concept of Home-based care does not just
address any disease condition but is intended for debilitating diseases that make
patients unable to care for themselves. In HIV/AIDS for instance, we do not provide
HBC to those who are HIV positive but to those with advanced AIDS illness. HBC
concerns those who are sick but still able to care for themselves as well as those who
are bedridden and unable to care for themselves.
Objectives of a Home-based care program
The main objectives of the HBC program are:
• To facilitate the continuity of the client’s care from the health facility to the home and
community;
• To promote family and community awareness of disease prevention and care related
to chronic illnesses;
• To empower the clients, the family and the community with the knowledge needed to
ensure long-term care and support;
2
Dow nloaded by NELSON KIIRU ()
, lO M oARcPSD| 26582732
• To raise the acceptability of terminally ill patients by the family/community, hence
reducing the stigma associated with the chronic disease;
To streamline the patient/client referral from the institutions into the community and
from the community to appropriate health and social facilities;
To facilitate quality community care;
To mobilize the resources necessary for sustainability of the service.
To ensure that the foregoing benefits are realized, home- based care should be
regarded as a holistic system of care with provisions for the following principles.
Principles of Home-based Care
The principles of home-based care include the following:
• Ensuring appropriate, cost-effective access to quality health care and support to
enable persons living with HIV/AIDS and other clients to retain their self-sufficiency
and maintain quality of life;
• Encouraging the active participation and involvement of the client and their family;
• Fostering the active participation and involvement of those most able to provide
support to the community at all levels;
• Targeting social assistance to all affected families especially children;
• Caring for caregivers, in order to minimize the physical and spiritual exhaustion that
can come with the prolonged care of the terminally ill;
• Ensuring respect for the basic human rights;
• Developing the vital role of home-based care as the link between prevention and
care;
• Taking a multi-sector approach to care and support;
• Addressing the reproductive health and family planning needs of persons living with
HIV/AIDS;
3
Dow nloaded by NELSON KIIRU
()
, lO M oARcPSD| 26582732
• Instituting measures to ensure the economic sustainability of home care support;
• Building and supporting referral networks/linkages and collaboration among
participating entities;
• Building capacity at the household, community and institutional levels;
• Addressing the differential gender impact of the HIV/AIDS epidemic and care for
persons living with HIV/AIDS.
In home base care, the care of the patients is extended from the hospital or health
facility where they are initially seen to their homes. This therefore implies that these
patients require certain services. These services form the components of home-based
care.
Components of Home-Based Care
There are four components of comprehensive Home-Based care. They include;
• Clinical care
• Nursing care
• Counselling and psycho-spiritual care
• Social support
All home-based care programs must contain some combination of the four components,
although the proportion of each component is determined by local realities and needs.
Clinical Nursing
Care Care
Psychological Social
& Spiritual Support
Care
Fig; components of home-based care
4
Dow nloaded by NELSON KIIRU ()
HOME Based
CARE(1)-2
QUESTIONS WITH
ANSWERS [2024-
2025]
Medical/Surgical Nursing II (University of Nairobi)
HOME-BASED CARE
CONCEPTS, PRINCIPLES AND COMPONENTS OF HOME-BASED CARE
In the last two decades, there have been dramatic changes in the health needs of our
populations due to the rise in non-communicable diseases, terminal illnesses, injuries
1
Dow nloaded by NELSON KIIRU
()
, lO M oARcPSD| 26582732
leading to disability, and HIV/AIDS. These changes have led to an increase in the need
for long-term care and the need for care to manage everyday living. To meet this
challenge, the ministry of health has had to adopt a different approach to health sector
policy and health care services including Home-based care approach.
The Concept of Home-Based Care
Home-based care is the care of persons with chronic or terminal illnesses extended
from the hospital or health facility to the patients’ homes through family participation and
community involvement within available resources and in collaboration with health care
workers.
It is a holistic and comprehensive care which relies on collaboration between the
hospital, the family of the client, and the community, in order to enhance the quality of
life of the patients and their families. The concept of Home-based care does not just
address any disease condition but is intended for debilitating diseases that make
patients unable to care for themselves. In HIV/AIDS for instance, we do not provide
HBC to those who are HIV positive but to those with advanced AIDS illness. HBC
concerns those who are sick but still able to care for themselves as well as those who
are bedridden and unable to care for themselves.
Objectives of a Home-based care program
The main objectives of the HBC program are:
• To facilitate the continuity of the client’s care from the health facility to the home and
community;
• To promote family and community awareness of disease prevention and care related
to chronic illnesses;
• To empower the clients, the family and the community with the knowledge needed to
ensure long-term care and support;
2
Dow nloaded by NELSON KIIRU ()
, lO M oARcPSD| 26582732
• To raise the acceptability of terminally ill patients by the family/community, hence
reducing the stigma associated with the chronic disease;
To streamline the patient/client referral from the institutions into the community and
from the community to appropriate health and social facilities;
To facilitate quality community care;
To mobilize the resources necessary for sustainability of the service.
To ensure that the foregoing benefits are realized, home- based care should be
regarded as a holistic system of care with provisions for the following principles.
Principles of Home-based Care
The principles of home-based care include the following:
• Ensuring appropriate, cost-effective access to quality health care and support to
enable persons living with HIV/AIDS and other clients to retain their self-sufficiency
and maintain quality of life;
• Encouraging the active participation and involvement of the client and their family;
• Fostering the active participation and involvement of those most able to provide
support to the community at all levels;
• Targeting social assistance to all affected families especially children;
• Caring for caregivers, in order to minimize the physical and spiritual exhaustion that
can come with the prolonged care of the terminally ill;
• Ensuring respect for the basic human rights;
• Developing the vital role of home-based care as the link between prevention and
care;
• Taking a multi-sector approach to care and support;
• Addressing the reproductive health and family planning needs of persons living with
HIV/AIDS;
3
Dow nloaded by NELSON KIIRU
()
, lO M oARcPSD| 26582732
• Instituting measures to ensure the economic sustainability of home care support;
• Building and supporting referral networks/linkages and collaboration among
participating entities;
• Building capacity at the household, community and institutional levels;
• Addressing the differential gender impact of the HIV/AIDS epidemic and care for
persons living with HIV/AIDS.
In home base care, the care of the patients is extended from the hospital or health
facility where they are initially seen to their homes. This therefore implies that these
patients require certain services. These services form the components of home-based
care.
Components of Home-Based Care
There are four components of comprehensive Home-Based care. They include;
• Clinical care
• Nursing care
• Counselling and psycho-spiritual care
• Social support
All home-based care programs must contain some combination of the four components,
although the proportion of each component is determined by local realities and needs.
Clinical Nursing
Care Care
Psychological Social
& Spiritual Support
Care
Fig; components of home-based care
4
Dow nloaded by NELSON KIIRU ()
