**3. Who provides palliative care?**

Palliative care can be provided by several categories of trained healthcare workers like physicians, nurses, and palliative specialists and by trained family and community care providers. Each category of providers has a unique role and training needs [7]:


**127**

living with HIV are:

• Pain relief

• Infection control [8, 9]

*Palliative Care in HIV/AIDS*

*DOI: http://dx.doi.org/10.5772/intechopen.85847*

loved ones and to consider the future [7, 8].

members and community volunteers [8].

these requirements, the guiding principles are to:

• Offer support to help patients live as actively as possible.

• Affirm life and regard dying as a normal process.

• Strive neither to hasten nor postpone death [2, 3].

• Offer support to help families cope during illness and bereavement.

• Treatment of other symptoms like nausea, fatigue, and weakness

• Supports (psychosocial, spiritual, for families and careers)

**4. Principles of palliative care**

trained community caregivers such as volunteers, medical assistants, counsellors, and family members could provide and create opportunity to expand the provision of palliative care in community setting. These trained community caregivers can provide basic care, support drug adherence, symptom management, referral, counselling on diet, and social support. Families and friends should be provided with support even after the death of the patient. Bereavement counselling is an opportunity to support the loss of the affected

• Palliative care should be included in the curriculum of medical, nursing, and other health professional students to ensure that healthcare workers are sufficiently prepared to care for PLWHA in all settings and are able to train family

People living with HIV need palliative care for symptom management, psychological support, spiritual support, and end-of-life support [8, 9]. Therefore, to fulfil

• *Provide relief from distressing symptoms to enhance quality of life***:** There are many distressing symptoms occurring in people living with HIV which need serious effort to improve quality of life, regardless of the stage of illness.

• *Integrate the psychological and spiritual aspects of patient care***:** Since palliative care is a holistic approach, services should consider the physical, emotional, spiritual, and social aspects equally. Therefore, interdisciplinary approach of services should be provided to better address the diverse needs of people living with HIV.

• Draw on experience and communication between the patient and healthcare provider to provide the best combination of interventions and medications.

The crucial elements of palliative care in people living with HIV are the relief of pain related to physical, social, psychological, and spiritual aspects and enabling and supporting caregivers to work. The ranges of palliative care needed for people

*Palliative Care*

**2. Settings of palliative care**

be given based on patient preference.

• Clinical diagnosis and treatment

providers throughout the hospital [6, 7].

**3. Who provides palliative care?**

• Procedure of referral for better facilities

school-based clinics, health centres, and work place clinics.

• Basic nursing care

• Communication skills

Palliative care includes a wide range of interventions to improve the quality of life of people living with HIV and their families. The delivery sites for providing palliative care include home, community, and facility based [6, 7]. However, it can

*Home-based palliative care***:** It is an affordable approach in resource-poor setting and plays a significant role for a large proportion of people living with HIV and their families. Most people living with HIV prefer home-based palliative care. It requires training and education for healthcare providers like nurses, medical doc-

*Community-based palliative care***:** These include clinics, day care centres,

*Facility-based palliative care***:** These sites include hospitals which provide both outpatient and inpatient clinical care by trained healthcare providers in the form of follow-up and admission. The specific palliative care activities carried out in hospital (facility based) based are assessment, symptom management, and consultation; discharge planning for all palliative care patients; and education of healthcare

Palliative care can be provided by several categories of trained healthcare workers like physicians, nurses, and palliative specialists and by trained family and community care providers. Each category of providers has a unique role and training needs [7]:

• **Traditional healers:** These groups of healthcare providers are linked between medical providers and community care providers in many parts of the health system and critical in improving access to care. The traditional healers are familiar to the family and individual needs. It is simple for traditional healers to explain the meaning of illness and death for families. Therefore, it is vital to

• **Family and community caregivers:** Friends, relatives, and others in the

community can be trained to ensure that the patient is comfortable. The use of

• **Medical providers:** The role of medical providers includes assessment, prevention, diagnosis, treatment, and management of pain and suffering experienced by PLWHA and their families. They can provide medical and psychological support including necessary drugs to control symptoms that occur because of HIV-related disease. Thus, palliative care should be an integral part of nursing and medical school courses. That helps medical providers to diagnose and treat people living with HIV and their families. For this purpose,

training and education of medical providers is critical [7, 8].

train and include traditional healers in palliative care [7].

tors, and community care providers. The training should focus on:

**126**

trained community caregivers such as volunteers, medical assistants, counsellors, and family members could provide and create opportunity to expand the provision of palliative care in community setting. These trained community caregivers can provide basic care, support drug adherence, symptom management, referral, counselling on diet, and social support. Families and friends should be provided with support even after the death of the patient. Bereavement counselling is an opportunity to support the loss of the affected loved ones and to consider the future [7, 8].

• Palliative care should be included in the curriculum of medical, nursing, and other health professional students to ensure that healthcare workers are sufficiently prepared to care for PLWHA in all settings and are able to train family members and community volunteers [8].
