1. Comprehensive HIV care

2. Holistic care SPIRITUAL SOCIAL PHYSICAL EMOTIONAL THE PERSON

3. group work In your Groups Consider the patient with HIV as the centre Plot around him the needs he has Now plot around him the people to whom he relates in his normal life

4. Every body needs To be able to trustTo feel loved and valued To have physical care and comfort To have peace of mind To be given respect and choice To have dignity To express his personality To have hopes and goals To have honest communication

5. Health care team Nurses Physiotherapist Occupational Therapist Nutritionist Counsellor Record clerk Spiritual care giver Volunteers Doctors Laboratory Pharmacy Administrators Community health workers/home support givers

6. Support is paramount in ccc HIV/AIDS care is stressful, especially so if the health worker is also positive Some issues or situations are very difficult and painful to face Health workers, including doctors, need to recognise this, and plan ways in which to support each other

7. Group work In your teams, discuss and define the meanings of Physical care Social Care Psychological/emotional care Spiritual care What are the components of the care?

8. Physical care Medical and nursing – treatment of illnesses and symptoms; lab and pharmacy support Physiotherapy – strengthening muscles and bone after illness and weight loss Nutritional advice Occupational therapy – to re-teach activities of daily living; teach new skills for income generation

9. Clinical care Opportunistic infections STI treatment Lab indicators of progression of disease TB treatment and follow-up ARV prescription Palliative care

10. Psychological/emotional The whole team – attitudes, how you greet patients, skills, knowledge, motivation and compassion Counselling Volunteers Community health workers – home support

11. Home based care Identify family care givers Encourage them to accompany the clients in every visit Educate them on patients condition and basic home based care in the following –Clinical care at home, nursing and psychological care, social and spiritual support

12. Home based care -ct Education and demonstration for patients and FCG on care Education on adherence, psychological support nutrition Involve the local community health workers to provide support and follow-up through DOTS Refer to community comprehensive care clinics for continuum of care

13. Social support Community support – NGO’s, church Private sector, individuals, organization Examples include post test clubs for positive clients, clubs for adolescents and youth Day care for children/adults where they can play games, share information etc

14. Spiritual care Care which relates to the spirit or soul of a person and facilitates its expression Spiritual means that within a person that relates to, or reaches out to, God, to the Creator, or to ‘something or someone greater’ It also relates to values such as love, beauty, joy, honesty, integrity, absolute standards of right and wrong, forgiveness

15. Specialized groups Identify space for child friendly services –Clean colorful toys, dolls, games, mat, crayon etc Youth friendly services –Games for older children and youth, videos, Television, reading materials etc

16. Aim of ccc To seek the best, always, for the patient To maximise the resources available To share the load To support each other

17. Summary A Comprehensive Care Clinic is an ideal situation It requires many staff, and good coordination There are not enough staff at most sites to run one Providing ongoing clinical care to people with HIV does not need to wait for a CCC to be established

18. The whole person The mind, soul and body