Soweto Hospice home visit

One Patient at a Time

Dr. Amy and I visited Soweto Hospice patient homes and saw the conditions that the Soweto Hospice sisters (nurses) and community care workers (like our home health aides) are confronting when caring for their patients. The sisters go over medications with their patients and evaluate their patient's status. They travel by car with their community care worker. Sisters see their patients about once a week. They also deliver food to patients who would otherwise not have anything to eat.

We encountered one patient who was in a particularly desperate situation. Her neighbor greeted us and told us of how badly things were going. 

She has had a stroke, has AIDS and is bedridden. She is unable to get out of bed on her own. Her neighbor brings her something to eat in the morning, but it is very little. There is no food in the home. The food the Soweto Hospice brings this patient is stolen by people living around her. There is no one in the home who will care for her and she has no way of caring for herself. 

Her community care worker is able to visit her two to three times a week and change her clothing and sparse linens. Community care workers visit their patients as often as possible but their case loads are high and they travel on foot. In between these visits this patient lies in bed and listens to a radio.

When we arrived at the home we were almost overcome with the stench of excrement. It had been three days since the last home care visit and the patient had been lying in bed since then unable to get out of bed. Her clothes were soiled and so was her bed. There were no dry clothes in her home. Dr. Amy, sister and community care worker bathed her and put a new diaper on her and put the least damp clothing on her. They turned her mattress over so the wettest side was on the bottom and replaced her linens with what was available.

The Soweto Hospice is reevaluating this patient's situation and is trying to place her in a long term care facility (similar to a nursing home).  

An update:  

Three days later at the weekly clinical forum meeting (similar to our interdisciplinary team meetings back home) that consisted of doctor, nurse, social worker and administrative staff, we discussed this very unfortunate patient.  All disciplines contributed to the discussion and a care plan was made.  Fortunately, a team member has a connection with one of the long term care facilities and planned to call her personally to ask for admission for this patient.  We also hope to bring her into the inpatient unit for respite while the final details of her transfer are arranged.  Before my eyes, this dedicated team of hospice individuals is working hard to improve lives one patient at a time.  

Amy Post-Grady, D.O.