**1. Introduction**

The economic recession in developing countries especially in sub-Saharan region has affected various sectors of the economy. This includes the health sector, leading to low productivity, poor service delivery and poor health outcome [1]. In some of these countries, home services are not available. The health sector is still trying to deliver basic health care services with the collective efforts of government but efforts to accomplish this seem not achievable due to the present state of the economy. Holistic health care is good, both ethically and practically but it is hard to find as any obvious expression of what holistic health care is or any plain explanation of its realistic usefulness especially in terminally ill patients in need of palliative care, which may require home care.

In most developing countries, patients generally report late to health facility due to a sequence response to event: improper health-seeking behaviour, economy and ignorance of the disease, treatment by unqualified and unorthodox medication, non-availability of personnel, equipment, culture/belief and family decisions [2].

Terminal diseases have often been linked with having one of the worst effects on the quality of life among affected patients and their families.

This chapter, therefore, considers what holism is and then what a holistic approach to illness might be, and how this might improve health care at home in a depressed economy.

#### **1.1 Learning outcomes**

By the end of this chapter you should be able to:


## **2. What is holistic care?**

Holistic care means reflection of the whole person, physically, psychologically, socially and spiritually, in the care and prevention of disease. These different conditions can be similarly important. They should be managed together so that a person is cared for as a whole. A holistic approach means that the health care providers are well versed with a patient's whole life situation. Maintaining one's health requires continuous effort to attain a balance of all aspects of life. To accomplish this balance, an amount of consistent factors must be considered when providing health care to patients/clients. Such factors include age, sex, family relationship, cultural influences and economic status. This broad approach to health care is recognised as holistic health care [3]. In order to have a good understanding of holistic nursing, Katie Eriksson, who is a nurse, came up with the theory of Caritative care that helps distinguish the relationship between a nurse and a patient and the concept of caring principles, which guide the nurses in decision-making. The theory of Caritative care comprises love, which is known as caritas. It shows the significance of regarding the self-esteem of a human being and holiness [4].

Almost all health care professionals would assert to put into practice holistic health care. It is obvious that; no one would declare or have the same opinion that their individual, professional or organisational practice was not holistic. Consequently, few if any of these professions, people or organisations make it apparent what they mean by 'being holistic'. They do not provide any explanation, or examples of how they manifest their holism. It is difficult to discover any criteria against which their success at being holistic could be measured. I doubt that many of the people, professions or organisations have any comprehensible conceptual understanding of what they mean by 'being holistic'.

The word holism has its foundation in two Greek words, both of which denote 'whole'. This first 'holos' is the base for holism and the second 'hale' is the base for

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**Figure 1.**

*Holistic/Palliative Management of Patient's Health Care and Home Situation in a Depressed…*

healing and health [5]. Health in general is believed to be concerned with the state of a person's mind and body, commonly meaning free from illness, injury or pain. Healing is the process of re-establishing health to a diseased, injured or damaged individual. Mariano defines healing as the consolidation of total human being in

body, mind, feeling and spirit [6]. Therefore, it is an associate to holism. 'Holism' in health care is a philosophy that emanates from Florence Nightingale who advocated care that centred on unity, wellness and the interrelationship among human beings, events and the environment [6]. She discerned the importance of such components as the environment, sense of touch, light, smells, music and silent expression in the treatment process [7], hence, reaching patients in fashions that went beyond rendering just physical care. The philosophy behind holistic care is founded on the thought of holism, which stresses that for human beings the whole is greater than the sum of its parts and that mind and spirit affect the body [8]. Holistic nursing has a higher cognizance of self, others, nature and spirit. This is the same approach Florence Nightingale integrated as the first holistic nurse, which centred on harmony, wellness and interrelatedness of human beings, likewise their surroundings. Holistic nurses also have the same self-care and self-awareness of body, mind and spirit as part of their belief structure (**Figure 1**). Through caring for themselves, it is believed it gives a holistic nurse the capability to have that same consciousness for the care of others [7]. Florence Nightingale once expressed the role of nurses as 'to put the patient in the best condition for nature to act upon him' [9]. She thought that touch, kindness and other measures of comfort, provided within the setting of treatment environment, are essential for nursing care. These assumptions are applied nowadays. Even these days, nurses are educated to deal with the environment and use touch, knead, eye contact, voice and other measures to make patients more relaxed. These nursing actions, known as 'the art of nursing', constitute the basis of professional nursing [10]. Currently, different fields, such as physics, mathematics, science, philosophy, sociology, medicine, nursing, etc. endorse the opinion that the honesty of an individual is much more complicated and greater

*DOI: http://dx.doi.org/10.5772/intechopen.92736*

than the sum of their individual parts [10].

*Diagrammatic presentation of the components of holistic care.*

### *Holistic/Palliative Management of Patient's Health Care and Home Situation in a Depressed… DOI: http://dx.doi.org/10.5772/intechopen.92736*

healing and health [5]. Health in general is believed to be concerned with the state of a person's mind and body, commonly meaning free from illness, injury or pain. Healing is the process of re-establishing health to a diseased, injured or damaged individual. Mariano defines healing as the consolidation of total human being in body, mind, feeling and spirit [6]. Therefore, it is an associate to holism.

'Holism' in health care is a philosophy that emanates from Florence Nightingale who advocated care that centred on unity, wellness and the interrelationship among human beings, events and the environment [6]. She discerned the importance of such components as the environment, sense of touch, light, smells, music and silent expression in the treatment process [7], hence, reaching patients in fashions that went beyond rendering just physical care. The philosophy behind holistic care is founded on the thought of holism, which stresses that for human beings the whole is greater than the sum of its parts and that mind and spirit affect the body [8]. Holistic nursing has a higher cognizance of self, others, nature and spirit. This is the same approach Florence Nightingale integrated as the first holistic nurse, which centred on harmony, wellness and interrelatedness of human beings, likewise their surroundings. Holistic nurses also have the same self-care and self-awareness of body, mind and spirit as part of their belief structure (**Figure 1**). Through caring for themselves, it is believed it gives a holistic nurse the capability to have that same consciousness for the care of others [7]. Florence Nightingale once expressed the role of nurses as 'to put the patient in the best condition for nature to act upon him' [9]. She thought that touch, kindness and other measures of comfort, provided within the setting of treatment environment, are essential for nursing care. These assumptions are applied nowadays. Even these days, nurses are educated to deal with the environment and use touch, knead, eye contact, voice and other measures to make patients more relaxed. These nursing actions, known as 'the art of nursing', constitute the basis of professional nursing [10]. Currently, different fields, such as physics, mathematics, science, philosophy, sociology, medicine, nursing, etc. endorse the opinion that the honesty of an individual is much more complicated and greater than the sum of their individual parts [10].

**Figure 1.** *Diagrammatic presentation of the components of holistic care.*

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

quality of life among affected patients and their families.

By the end of this chapter you should be able to:

• review holistic care and identify its principles

• understand palliative care and its principles

• recognise the relevance of spirituality in health care

• assess the impact of economic depression on health

care in terminally ill patients and the elderly.

understanding of what they mean by 'being holistic'.

• assess the home care situation in a depressed economy

depressed economy.

**1.1 Learning outcomes**

**2. What is holistic care?**

Terminal diseases have often been linked with having one of the worst effects on the

• discuss the integration of palliative/holistic care in clinical and home-based

Holistic care means reflection of the whole person, physically, psychologically,

socially and spiritually, in the care and prevention of disease. These different conditions can be similarly important. They should be managed together so that a person is cared for as a whole. A holistic approach means that the health care providers are well versed with a patient's whole life situation. Maintaining one's health requires continuous effort to attain a balance of all aspects of life. To accomplish this balance, an amount of consistent factors must be considered when providing health care to patients/clients. Such factors include age, sex, family relationship, cultural influences and economic status. This broad approach to health care is recognised as holistic health care [3]. In order to have a good understanding of holistic nursing, Katie Eriksson, who is a nurse, came up with the theory of Caritative care that helps distinguish the relationship between a nurse and a patient and the concept of caring principles, which guide the nurses in decision-making. The theory of Caritative care comprises love, which is known as caritas. It shows the significance of regarding the self-esteem of a human being

Almost all health care professionals would assert to put into practice holistic health care. It is obvious that; no one would declare or have the same opinion that their individual, professional or organisational practice was not holistic. Consequently, few if any of these professions, people or organisations make it apparent what they mean by 'being holistic'. They do not provide any explanation, or examples of how they manifest their holism. It is difficult to discover any criteria against which their success at being holistic could be measured. I doubt that many of the people, professions or organisations have any comprehensible conceptual

The word holism has its foundation in two Greek words, both of which denote 'whole'. This first 'holos' is the base for holism and the second 'hale' is the base for

This chapter, therefore, considers what holism is and then what a holistic approach to illness might be, and how this might improve health care at home in a

**250**

and holiness [4].
