VISITING ANGELS NURSING AGENCY LTD., KENYA ANGELIC NURSING

INTRODUCTION A private limited company incorporated in 2012 Not a franchise Motivated mainly by the passion to start a business in nursing practice, with a previous experience of home-based care as a young girl growing up in the countryside.

Our Vision, Mission, Values To be a centre of excellence for provision of high level nursing and auxilliary home-based care services. Our Values Empathy Respect Integrity Compassion Responsiveness Friendliness

Our Mission To provide exceptional, full range, high quality, cost effective care to patients of all ages in the comfort of their homes or in the hospital, allowing them to experience compassion, empathy, respect and dignity, as they receive one-to-one individualized nursing care and auxilliary service provided by caring professionals.

Our Services Home Based Care Palliative care Disease management programs for the elderly Training of in-service nurses and patient attendants Managing retirement homes

Trends of engagement Practice of HBC in Kenya- close to 30 years, by individual nurses with no registered businesses. Noted progress in the last 15 years - nurses registering business entities for HBC. Expected in future - More registered HBC business entities, as nurses aspire to start formal businesses and the HBC industry gains popularity and structure. Resistance to the practice- By family members and doctors and no consideration by insurance companies. To-date, many family members will not allow our staff to wear uniform while in the homes, for own reasons

Trends.... On numbers, at inception, we had only about five (5) HBC enquiries per month on care of older persons but currently we get more than 30 similar enquiries from families, hospitals, individuals . This may be due to increased awareness on HBC and increased marketing on our part Increased Hospital requests for patient attendants- to supplement staff shortages, as opposed to the past where this was not considered an option. Insurance companies have softened their position on HBC but depending on member’s policy

Challenges Lack of recognition as partners in the continuum of care to the Older persons Lack of licencing specifically as HBC providers in the industry No professional indemnity policies by insurance companies No regulation and /or standardisation of our practice No recognition of caregivers/ patient attendants as a key resource for HBC Patient attendants – no recognition by Nursing Council of Kenya as providers of HBC and their curriculum / training institutions too There is no standard curriculum for training patient attendants

Challenges HBC in the private sector adopts a fee-for- service financing model as we have no financial support from donors or governments. Businesses require frequent capitalisation when some clients default on their payments. Unaffordability - As a result of the above, many older persons cannot access the HBC even on a high need basis due to unaffordability. Who is family?

Challenges…. No specialised geriatric resources- Currently, there are no Geriatric trained doctors and nurses in the country, for consultation and referral purposes. Needed are Courses to be introduced in the respective curriculi and develop specialised programs at the universities and the medical colleges. The cost of running the HBC business, which are SMEs is very high. Government to consider subsidizing the cost of HBC to the elderly; tax-exempt legislation on all medication and supplies to older persons,

Opportunities Integration with other private health care instituitions to compliment each other; in areas of research, capacity building, partnership in training the patient attendants. Such as AKUHN, KNH,KMTC, KEMRI etc Develop partnerships with health providers (private or public) that allow the older persons under our care to access specialised medical attention such as emergency services, diagnostics etc Adopt legislation that will markedly subsidise the cost of medical supplies and equipment for older persons

Opportunities….. More aggressive government involvement Evident is the Health and Ageing Unit in the MOH, Ministry of EA Community, Labour & social protection, NHIF benefits for the elderly Provide free NHIF coverage for all older persons over 60 years . Currently the premiums are kshs. 500 per month which is unaffordable. Include a home-based care benefit in the NHIF policy and private health policies

Opportunities….. Cultural considerations- retirement homes are not yet culturally acceptable. Need to create awareness for and develop community geriatric centres. Spearhead health promotion and preventive programs to cut on costs spent on curative

Opportunities… Corporate organisations invest in home- based care; sponsorships to conferences, scholarships, research, projects, donations of supplies and /or medication , direct investment etc to build capacity and sustainability of the industry and increase reachability to the older persons. Technology -coordinating activities, tracking clients’ progress, documentation, submitting reports to the office and the doctor, staff management ( clocking in and out,) leave, shifts , staff availability, emergencies, quality assurance, Adopt-an-older person for healthcare- AHN ( Angels Healthcare Network) project in Embu County. AHN is a non-profit organisation for healthcare programs for the elderly.

Opportunities- Participating in the national agenda

Opportunities- Creating awareness through Participation

Opportunities- Education, Empowerment

Opportunities… Develop systems that will support family caregivers as they take care of their elders in their homes. At AHN, we are developing geriatric centres in the various communities, to cover predetermined catchment area Empower older persons - on self-care- encourage financial management, education in younger people on old age issues, create older persons friendly communities Encourage the growth of the home-based care sector as a major player in the mainstream healthcare system, to attract youth

THANK YOU ASANTE SANA