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**Chapter 15**

**Abstract**

ies for training of families on home care.

care, which may require home care.

**1. Introduction**

Holistic/Palliative Management of

Situation in a Depressed Economy

*Akon Emmanuel Ndiok, Emilia Oyira and Busisiwe Ncama*

In most middle and low economic nations, problem in the active management of health complaints is patients defaulting on follow-up appointments, attributable to financial constraints and cost of health services due to economic recession. This increases the danger of aggravation and deterioration of the condition and leads to re-hospitalisation. Most terminally ill patients and elderly prefer to be cared for at home by family caregivers or paid health professionals towards the end of their life. Holistic/palliative care is a key component of home health care. Current structure of health and social care services shows that the home is gradually becoming a significant location of long-term care. Holistic care as advocated by Florence Nightingale and others takes cognizance of the care of total human being looking at the spiritual, physical, social and psychosocial care of individual. Quality care for patients and their families can be achieved by establishing principles of holistic/ palliative care as an integral part of daily practice both in the hospital and home care, as advocated by the WHO. Challenges in seeking to do this can be overcome if adequate funding is allocated for palliative care activities and setting up machiner-

**Keywords:** depressed economy, holistic/palliative care, home care, management

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

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].

Patient's Health Care and Home
