Physical Health Nepal Project #21246

Hospice Care for the Terminally Ill

by Binaytara Foundation

Project Report | Mar 14, 2016
Comfort for the terminally ill

By Tara Shah | Project Leader

Thank you again for your continued support to the Binaytara Foundation’s Nepal home hospice project. Since we reported to you last, the demand for the hospice program is growing everyday. Currently there are 6 active patients that are receiving hospice care. We recently purchased a motorcycle for the home visit team so that they can visit patients in areas that are otherwise inaccessible.

Before the BTF home hospice program was started, we conducted a survey among terminally ill patients and their families admitted to a local cancer hospital. One of the terminally ill patient Ratna was admitted to the hospital for the treatment of small cell lung cancer. But her disease had progressed too far that treatment would not work. She had difficulty breathing, pain, and depression. Her daughter said, “I feel very sad and helpless that I can not alleviate her suffering.” If Ratna had an option for home hospice care, her quality of life would have been much better. But this happened before the BTF home hospice project was started. There are numerous such individuals and families like Ratna who are suffering. Your generosity and compassion can give these terminally ill patients and families a sigh of relief.

With BTF home hospice, our nurses and other hospice team members visit patients at their home and provide comfort care there. Thanks to your support, we have been able to help terminally ill patients live the last few months of their lives comfortably. In addition to providing in-home hospice care, BTF is also pioneering the use of technology in Nepal’s healthcare settings. The BTF home hospice program uses an Electronic Medical Record (EMR) system to document patient health information. This is one of the very few programs that currently use EMR in Nepal.

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Dec 17, 2015
Home hospice program started

By Tara Shah | Project leader

Hospice nurses with patient during a home visit

It is our great pleasure to share with you today that 15 registered nurses from Nepal completed a hospice training program utilizing the curriculum called Palliative Care Toolkit, developed by the Worldwide Palliative Care Alliance. Binaytara Foundation volunteer Tricia Reynolds, a hospice and palliative care nurse practitioner from Boise, Idaho, recently traveled to Nepal to train the nurses. The primary focus of the training was hospice visits in the home, though some ideas will be applicable in the hospital setting as well.

Tricia says, "The nurses are young and enthusiastic, and have embraced the palliative care concepts. Palliative care is holistic care, and includes addressing the social, psychological, and spiritual needs of patients with incurable diseases, as well as their physical needs. We have practiced communication skills, and how to help families talk about difficult things."

Tricia and the nursing team visited three families in their homes during the training. According to Tricia, "these visits have been much appreciated, at least by the families. For one family we encouraged them to have the patient take his pain medicine at bedtime, so he would sleep better, as the patient denied pain but was up all night, which was tiring everyone out. We also encouraged allowing the patient to eat for pleasure, rather than having it as a source of conflict in the home. For another we facilitated discussion about stopping the oral chemo, which the patient wanted due to side effects, but some of the family was reluctant. For the third family we simply advised to put the lactulose in juice to prevent constipation. These may seem like little things, but these little things can make a big difference for patients and families coping with incurable diseases."

With this training and continued support from experts, we expect these nurses to be able to provide hospice care to 10 families per month by July 2016. At this time, the BTF home hospice program covers residents of the city of Patan in Lalitpur district. The terminally ill patients in Nepal are underserved due to lack of trained hospice care providers and the lack of organizations offering home hospice care. You can help us change that. With your help we can provide hospice care to many more needy patients and expand the program outside Patan and Lalitpur district.
Please support our home hospice program so that we can provide hospice care to many more families.

Hospice training - practice session

Tricia with patient and family during a home visit

Hospice Nurses during training

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