Imagine if respected members of the community could help teams of doctors and nurses do effective home visits to care for immobile or terminally ill patients. Volunteers at Pallium India have done exactly that in the state of Kerala in the south of India. Pallium India provides inpatient and outpatient palliative care for seriously ill patients and is currently hosting our group from the University of Iowa.
Pallium India faced the challenge of how to get health workers to remote areas and to maintain contact with patients and their families. Their innovative solution was to train community members as a primary point of contact for the patients and their families. Over 2000 people in the state of Kerala have volunteered to act in this liaison role between their community and Pallium. They underwent a 2 day training—8 hours of classroom work and 8 hours of practical training during home visits.
Volunteers at Pallium are respected and crucial members of the team before, during and after the home visit. First, they make sure that the vehicle carrying the team does not lose precious time trying to find the right house. Getting lost can be demoralizing for a team, but more importantly, it robs time from the patients and families.
Pallium volunteers come to the home visit, update the team on the interval since the last home visit, keep the paperwork straight, stay current on the new plan and how soon the volunteer needs to assess the patient for a response to any change in therapy. The opinions of the volunteer are voiced and trusted. Sometimes the volunteer better understands the level of caregiver fatigue, or knows the family or the history better than the rest of the team.
New volunteer with me and the Pallium nurses
Volunteers serve Pallium because of their own personal stories or due to the full spectrum of care that Pallium provides without regard for the ability to pay. Some volunteers work every day (and have their cell phone on at night). The volunteers build support for Pallium in their communities. In turn, Pallium has trained them well and there is no question about their role on the team.
Well done Pallium India! Creative use of team work and resources to optimize care and to ensure good follow up for patients!
Thanks again to Professor J0 Eland for her photos and to Team Iowa for their humanism and perceptive engagement during home visits and in class.