Sneha Deepam - Home Care or Domiciliary Care Service in India

Home care or domiciliary care is supportive care provided to patients in the comfort of their own home. More elderly people and patients all over the world have begun to prefer remaining at home rather than use residential, or institutional-based nursing care which they feel can alienate them from home or get expensive sometimes. Depending on the service providers, Nurse Aides or caregivers offer professional health care services such as wound care and physical therapy or life assistance services such as helping the client eat, bathe and use the toilet and offering companionship or sometimes a combination of both the services. Sneha Deepam, meaning ‘a light of love’ is a Domiciliary Care service provider in Chennai, Tamil Nadu. The charitable organisation empowers women from economically challenged backgrounds by offering training, funded by the organisation, and thereby enabling immediate employment as Nurse Aides.

Medindia met with Sneha Deepam to get an insight of Domiciliary Care services in India.

Q. What prompted the inception of Sneha Deepam?

A. Sneha Deepam is a joint venture by an ecumenical group; members from different churches observed that there were more and more nuclear families emerging as children started to work away from home, which invariably left the elderly behind. Their second observation was the number of unemployed women and school drop-outs that needed employment because they were either abandoned women or widows. Hence Sneha Deepam facilitated both providing care for people who needed it and employment for women.

Q. How does the organisation operate?

A. Sneha Deepam is a registered organisation. The committee is inclusive of the President, Vice President, Secretary and other members who are doctors and consultants. Also, there are altogether four executive committee meetings and four general body meetings held in a year.

Q. Who are the potential clients?

A. Families with elderly patients or people with dementia, Alzheimer or people of any age group who have physical or mental challenges. It is not possible especially for working people to be with patients at home and to be constantly by their side. At the same time it is all the more complicated leaving the elderly behind who are usually visually impaired, have brittle bones, and thereby prone to accidents. So our clients look for someone who will look after patients and help them with routines like eating, bathing, walking, sitting on chairs, clean them after they use the toilet etc.

Q. Who is an eligible Aide Worker?

A. The Aide Workers are called Nurse Aides, but they are not nurses or medically qualified. As mentioned earlier they are women who have been made employable. Eligibility for hiring includes basic schooling, the girls must have passed 8th standard, should be healthy and well built to help move patients. It is a requirement that potential Nurse Aides have a pleasing personality which usually reflects on the way they present themselves during the interview. It is mandatory that the Nurse Aides are hygienic and compassionate.

Q. How do you find the Nurse Aides or how do they find you?

A. Initially the potential employees were members of Churches and the opportunity for employment was spread by word of mouth, through existing Nurse Aides. The organisation also places free ads and soon after a training programme is over, clients request for Nurse Aides. The clients usually approach the organisation since they may be stationed anywhere in the world, for example the US or Singapore and they keep us informed that they are in need of Nurse Aides for their parents in Chennai.

Q. Does this mean you send Nurse Aides outside of India?

A. No, we don't. Employment for Nurse Aides at Sneha Deepam is only within Chennai but there are organisations that send Nurse Aides all over India. Also, there is demand for Nurse Aides here and more people are needed.

Q. What is the procedure to be hired as a Nurse Aide?

A. Potential Nurse Aides have to produce their certificates while appearing for the interview. They are also required to present an approval letter by their father or husband. They are then interviewed by a panel of committee members inclusive of three doctors. The training begins the very next day.

Q. What is involved in the training?

A. A trained nursing superintendent is hired for a period of three months. The trainees spend a month in the classroom, six weeks in the Government General Hospital with the geriatric department and two weeks in various Old Age homes in the city. The classroom training is given by a retired nurse, committee members and doctors. Visiting consultants are arranged by the organisation to give talks on motivation, dental hygiene and on falls and fractures by orthopaedic surgeons.

The training is also on personality development of the Nurse Aides, hygiene, conduct on the premises of the client, patience while dealing with the elderly, listening, administering oral hygiene, sponge baths, cleaning of genital areas, prevention of bed sores, cutting nails, making beds with patients in it, transferring of patients from wheelchair to bed and vice-versa.

Q. What kind of instructions do you give the client?

A. Clients are informed that the Nurse Aides are not permitted to give injections, pass Ryle’s tube, handle urinary catheters or give enema. The Nurse Aide should be by the side of the patient at all times, even while eating her food. Clients have to take responsibility for items at home.

Q. How do you organise the funding?

A. Sneha Deepam is a voluntary organisation and the primary source of income is from the client's registration fee which is Rs. 3000/- a year and other goodwill sponsors.

Q. What is the approximate fee for a Nurse Aide?

A. The payment for a Nurse Aide depends on the services she provides and for the number of hours she provides. For day shift services from 8 a.m. to 6 p.m., and night shift services from 7 p.m. to 7 a.m. a Nurse Aide gets Rs. 4150/-. A fulltime Nurse Aide gets Rs. 5,300/-. Clients give cheques to the Nurse Aides which is encashed on the first of every month. The Nurse Aides bring their review cards where the clients write their feedback on the conduct and services.

Q. How does Sneha Deepam invest on Nurse Aides?

A. The training is sponsored by the organisation which amounts to Rs. 5000/- on each trainee. The trainees are also provided Rs. 400/- per month on transportation charges, get two Sunday's off every month. It is mandatory that the Nurse Aides work with the organisation for at least one year and during this period their certificates are retained. The trainees also pay Rs.50/- per month towards their training.

Q. What are the challenges faced by Sneha Deepam?

A. When the organisation was launched, there were four programmes a year. As soon as there were twenty potential people, a training programme began. Unfortunately in the last one year the organisation hasn't recruited a single person to be trained. However on a positive note, there have been 300 Nurse Aides trained by Sneha Deepam between 1996 and 2000.

Q. Why has it been hard to recruit?

A. They get married, motherhood sets in. Some find jobs in clinics or old age homes, while some lose motivation down the road. Some also take up jobs in malls and export factories. All said and done, it's a profession that requires patience and constant self-motivation. We are happy for girls who pursue higher education.

The urbanized Indian metros with increasing numbers of ageing Indian population with small nuclear families is opening up a new opportunity for ancillary care for elderly people, more so if they are infirmed due to limited mobility or suffer from dementia. The option for families is either a nurse at home or institutional care. Medindia wishes to keep its members informed of such facilities and will interview such organizations who provide professional services. Other similar organizations are welcome to contact us and we shall carry their profile in our support group community section of the website.

Source-Medindia