1. Community owned programs in palliative care Dr Suresh Kumar

2. COPP - Rationale Patients with advanced diseases require continuous care and attention for the rest of their lives They are also in need of regular social, psychological and spiritual support in addition to the medical and nursing care Care should be readily accessible and available as close to home as possible There is enough potential available in the community to build a ‘safety net' around these patients

3. Palliative Care in the Community

4. Care in the community by volunteers The Foundation: Establishing a social support system Food for patients Transport education support for children Adding on local expertise: Emotional support Basic nursing chores Help with mobility

5. Primary Health Care Capacity building at the primary health care level Training Drugs and equipment Integration between the primary health care and community owned services

6. Interface between ‘specialists’ and the periphery Trained Health Care Professionals as the link Professionals employed by community based organizations Professionals working in primary health care facilities in the region Professionals employed by the ‘specialist institution’

7. Community Volunteers Professionals Capacity Building in layperson community Basic supportive services in the community Sensitization for ‘level I’ Training for ‘level II’ Basic Principles of PC Psycho social assessment of patients Communication skills/ emotional support Basic Nursing chores Documentation

8. Professional support for community owned services 1.Physician 2.Palliative care nurse 3.Auxiliary Nurse in PC

9. The matrix of community owned palliative care program Medical Component Nursing Component Sensitised community volunteer Trained community volunteer One can start with any component and build the others

10. COPP – Practice

11. Neighborhood Network in Palliative Care Looks after more than 10,000 patients at any point of time- all the services are free All the expenses for delivery of care (including salaries, cost of medicines, food for the family, educational support for the children) raised locally

12. NNPC - structure Network of trained volunteers in the community Support system by trained professionals, institutions and organizations Palliative care institutions as nodal centers

13. Volunteers Anyone who wants to contribute in the efforts to reduce the suffering of people living with advanced diseases Structured training given to those who are willing to spend at least two hours per week for the work

14. Training Training as part of generation and dissemination of knowledge 16 hours of theory 4 days of practical work

15. What do volunteers do? Regular continuous emotional support for the patients and family Social support to the patients Wound care, bedsore prevention, mobility Spread the idea of palliative care in the society Fight social stigma to cancer, AIDS etc. Organisation & administration of palliative care services

16. Community Participation in Palliative Care – Palliative Care is everybody’s business More than 12,000 community volunteers from various walks of life Majority belong to lower socio economic strata Majority are young people

17. Palliative care in campus

18. Palliative Care is everybody’s business – Police in Palliative Care Kerala Armed Police Battalion IV runs its own palliative care unit – Probably the first of its kind in the whole world! City Police in Calicut a major partner in palliative care in the city

19. Emerging Kerala Model in Palliative Care Public health approach in palliative care Community participation as a core principle Need based evolution State owning up responsibility. Planned activities in Government sector

20. Thank You! drsuresh.kumar@gmail.com