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Palliative Care



The basics

In South Africa


Related Research

The basics

»  Palliative care is defined by the World Health Organisation as the active, total care of a patient whose disease is not responsive to curative treatment. It focuses on quality of life rather than on cure or recovery.

»  Traditional palliative care models were originally designed to deal with cancer patients but have been altered to meet the complex needs of people infected with HIV/AIDS.

»  Traditionally, the formal health care system provided primary health care services and hospital nurses are generally restricted in dealing with terminal patients because of their limited knowledge of palliative care, and also because hospital policy seeks to maximise patient turnover.

»  Palliative care was mainly provided by hospice, an international non-governmental organisation that was initially developed in the United Kingdom to provide care for terminally ill patients in their homes or in hospitals or within in-patient wards run by the organisation.

»  Hospice traditionally cares for patients in an in-patient ward. It provides holistic services in addition to palliative care, including psychological and religious support.

»  In the context of AIDS, the process of palliative care itself must be adjusted. Palliative care can begin long before the terminal stage of the illness, which is when palliative care usually begins, with the results of the HIV test and end with the support of family members after the patient dies.

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In South Africa

» In response to the changing needs and increasing numbers of terminally ill patients, some hospices have expanded their focus to include home-based care in the community. This is called the Integrated Community-based Home Care Model (ICHC) which being piloted at 7 hospices nationally.

» The ICHC model is a unique form of care because it aims to support both the patient and the patient’s family before. Community caregivers are selected from the community to It also includes neighbours and extended family, and various agencies in the extended community, including the formal health care sector, community-based organisations and hospice, that are also focused on caring for the patient and family. This represents a continuum of care and support for patients between hospitals, clinics and hospices.

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Hospice Association of South Africa (HASA)
Contact: Jenny Mills
Tel: (021) 531 2094
email: hasa@iafrica.com

South Coast Hospice, Port Shepstone
Contact: Kath Defilippi
Tel: (039) 682 3031
email: schospkz@venturenet.co.za

SCH developed an Integrated Community-based Home Care model (ICHC) in response to the rising number of HIV+ people being referred to our program. ICHC, which involves collaboration between the Hospital-Hospice-Primary Health Care clinics and community, is now being piloted at seven sites across five SA provinces. Currently South Coast has four ICHC teams as well as a specialised "Children's Team" involved in our Memory Box project which helps to facilitate a normal grieving process for potential orphans.

Pretoria Sungarden’s Hospice, Pretoria
Contact: Sue Cameron
Tel: (012) 348 1934

This hospice is another pilot site for the ICHC model, but is a leader in nutritional education for their patients.

National Department of Health
Contact:Cornelius Lebolle
Tel: 012-312-0132 or
Cell 082-414-8961

Palliative Medicine Institute
Nonhlanhla Duba and Selma Browde
Tel (011) 728 3103

Related research

Reaching out, scaling up: Eight case studies of home and community care for and by people with HIV/AIDS UNAIDS (2001)

South Coast Hospice’s Community-Based HIV/AIDS Home-Care Model, HIV/AIDS and STD Directorate
Department of Health (1999)


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