Home Community Based Care
44 Community Health Workers that work directly in the community and deliver services in the patient’s own homes.
4,5 hours per day.
Focus on: Health Screenings, Basic Care, Referrals to Primary Health Care, Prevention and Promotion, Wellness and Self-Management of Community Members
In close partnership with Primary Health Care and Government structures.
Care is free of charge.
** Funded by Department of Health
Definition of Home Community Based Care:
The provision of health services by formal/informal caregivers in the home; in order to promote, restore and maintain a person’s maximum level of comfort, function and health including care towards a dignified death.
Goals of Home Community Based Care:
- 10% Basic Care
- 90% Health Screenings of Households and Crèches; including promotion of Wellness and Self-Management with Primary Health Care support.
- To promote health and prevent illnesses.
- To support screening and health
- To mobilize around community needs.
- To identify household’s health needs.
- To provide psycho-social support to community members.
- To identify and manage minor health problems.
- To support screening and health promotions programs in the community.
- To support continuum of care.
- To ensure de-hospitalization and family involvement.
- To help users maintain independence and achieve best possible quality of life.
- To develop user’s ability to self-care.
Services and Guiding Principles:
Home Community Based Care recognizes people’s capacity to self-help and involves a comprehensive range of context-specific interventions that positively influences environmental- and personal factors such as psycho-social abilities, lifestyle issues, behaviour patterns and habits. It’s an array of interventions that support the actions people take to maintain health and well-being; prevent illness and accidents; care for minor ailments and long-term conditions; and recover from periods of acute illness or hospitalization.
The services are Patient-centred and Multi-Professional.
Community-based participatory approach.
- Needs screening, health education and support to stay healthy, safe and free from abuse and neglect.
- Compromised functional status requiring personal care and support.
- Requires adherence support.
- Requires promotion of wellness.
- Requires guidance towards self-management.
- Requires Primary Health Care Interventions/Support.
- Requires end of life care.
- Requires multi-disciplinary interventions to be holistically healthy and function (as possible) as a member of a family/the community.
- 1 Home Community Based Care Manager
- 2 Professional Nurse Coordinators
- 1 Community Health Workers Supervisor
- 44 Community Health Workers
- 1 Integrated School Health care worker (** part of NHI Pilot project in Eden Health district)
- 1 Occupational Therapist
- 1 Occupational Therapy technician
- 1 Social worker (shared with Intermediate Care)
- 1 Spiritual worker
- Outsourced Physiotherapy: Integrated Physiotherapy (George)
- 1 Psychologist
- Health Screenings
- Referrals to Primary Health Care
- Wellness Support
- Basic Medical Care
- Palliative Care
- Occupational Therapy
- Provision of Assistive Devices and Wheelchairs
- Adherence Support
- Psycho-social- and Emotional Care
- Spiritual Care
- Family Support and -Empowerment