The Power of Home Visits

[NAMARA ARTHUR ARAALI]

I have been an HIV/AIDS Counsellor for the last 16 years, working with TASO - The AIDS Support Organization and Medical Research Council unit on HIV/AIDS in Uganda and Home visiting patients has been integral to my work. Without home visiting the patient your understanding is not complete. There is a lot to learn from a home visit. As I always say, health is made from home and repaired in the hospital. What we used to do is to seek the consent of patients to be visited at home. Those who declined had their reasons and we could not home visit them. It is very stimulating on the part of the patient to have a discussion with him or her in an environment that is familiar. The patient becomes more relaxed and it strengthens the relationship between the provider and the recipient.

That was then before I was introduced to CLCP. With SALT and an aspect of inclusion the situation becomes even more better. You high light the strengths in a local context, you appreciate in a local context, stimulate and more importantly Learn. We learn a lot during SALT visits

he last two years, SALT and CLCP gave a new dimension to his work: the appreciation of strengths has deepened the relationship between patient and caregiver." 

 

Before learning about SALT and CLCP, I used to conduct home visits on the premise that I am more knowledgeable than the people I am going to home visit – Actually my intentions were always to identify their problems and educate them on how to live healthier lives. With SALT and CLCP, my attitude changed, I conduct home visits with an open mind; to learn how these patients live within their communities, how they relate with their family members, learn how they keep their drugs, learn how their home environment is, appreciate their strengths and promote dialogue among family members. The patients learn through the information shared during the discussion. I no longer focus on the patient a lone but also other family members the patient lives with. When family and community members get involved in the care of their patients, the community moves towards competence. 

My best regards to you

[Marie Lamboray]

Thank you Arthur,

For your readers, other blogs about home visits are available on Ning. Please search in the OUR STORIES page by typing "home visits" or selecting the tag. Here are four of them:

Home visits lead to wider community response, by April Foster on February 9, 2014
http://aidscompetence.ning.com/profiles/blogs/home-visits-lead-to-w...

What makes home visits effective?, by Rituu B. Nanda on April 24, 2012
http://aidscompetence.ning.com/profiles/blogs/what-makes-home-visit...

The Power of a SALT Visit: SALT connects neighbour to neighbour, by NAMARA ARTHUR ARAALI on April 24, 2012
http://aidscompetence.ning.com/profiles/blogs/the-power-of-a-salt-v...

The virtue of home visits, by Phil on March 25, 2008
http://aidscompetence.ning.com/profiles/blogs/2028109:BlogPost:303

 

[Onesmus Mutuku]

Sounds really interesting -here is our encounter in Mauritius

The Mauritius coaches’ team in their ongoing Platform members learning visits visited one of the platform members- SAFE/APEL. The SAFE/APEL team does home visits two times a week. They are known to this neighbourhood. We join them on Friday afternoon - for a sequence of around 5 homes in the same neighbourhood. As we walk down, we notice some sequence of actions on sanitation and many more strengths. The government is helping the neighbourhood set up houses. The neighbours are concerned of their electricity as well as drainage systems. They are awake to this issue and are doing something. Even without asking, they highlighted their strengths so well. In the home of *Sabrina, she is really happy too and took us to where she is digging her bathroom together with a toilet. Her neighbour is proud of her children. Her son was the best pupil for the 2013 certificate for primary education (CPE) in the Neighbourhood primary school. The trophy is well displayed in the house and the whole family is happy about it. In the midst of the poverty here, they seemed to be working pretty well together. Sabrina recalls, when we do not have something to eat from our house, we are not worried since we can get help from our neighbourhood next door. That’s how we live here. We are one''

We learnt a lot from the families we visited, they were happy to be visited. They invited us back. One old lady said to us as we moved into the house of her daughter ' I am so poor, but my doors are open, come and visit me too. 

At the end of the visit, we gathered at Apel offices for some reflections. The most significant lessons was how home visits helps to establish, deepen relationships between the team, families and neighbourhoods. Ketty one of the Apel staff recalls, ''People see you as a friend, because you are there for them. Not because you brings things but because they see you as a person who care. You find time to visit them even in their poor conditions. Trust builds over time and they begin to open up to even deep concerns they may be going through. This is useful because many of the women in the neighbourhood we visited are single mothers; their husbands have run away and left them to fend for the children by themselves.  The visit helps to encourage, she added'' 

[NAMARA ARTHUR ARAALI]

Dear Phil,

Thanks for your comment, what we used to do then was more expertise-based and  result - focused approach but now on top of seeking consent  we moved  toward more involving and process - centred approach. We learn from and appreciate the strengths of our patients. When you are talking about ART adherence first appreciate the effort of the patient to take drugs, to seek medical care and his or her will to live. One even appreciates better the strengths of patient when you do a home visit. Some of them come from very far places and they are weak! 

[Phil]

Arthur, 

Your picture shows me the power of appreciation. I like it a lot. 

In your post you say that 'What we used to do is to seek the consent of patients to be visited at home. Those who declined had their reasons and we could not home visit them.' Does that mean that you have changed that position? If so, what do you do now? 

Best regards 

Phil