By the year 2000, scientists estimate that close to forty million people will be infected with HIV, the virus that leads to AIDS. There is the chance that someone you know or someone very close to you will get this disease.
Even today, in many places, local health services cannot cope with the number of people needing care. There are not enough trained staff, beds, drugs or facilities to help care for all the people infected with AIDS.
These people will have to go home for care. At home, patients are surrounded by family and friends. Patients can eat, take a bath or sleep when they like. They can live with dignity and love.
Home care does have some disadvantages. Sometimes the family cannot afford the meals and medication that is prescribed. It can be frustrating and tiring to look after someone who is sick. But even with a limited amount of money, good care can be given and both the patient and relatives can prepare for the future.
Choose a room with good ventilation and light for the patient to live in. It should be quiet and clean. Make sure the patient is comfortable. Let him or her participate in family life. There is no danger in sharing a room with someone who has AIDS.
The HIV virus is spread through blood, semen and vaginal juices. So, when you are caring for the patient and coming into contact with these bodily fluids, wear latex rubber gloves and wash your hands often. If no latex gloves are available, use gloves made of another waterproof material such as plastic. This will help prevent the virus and any other illnesses from spreading. If you cannot get gloves, keep your hands clean. Avoid getting cuts on your hands because there is a risk of getting infected when the patient’s bodily fluids come into contact with an open sore or cut.
Wash soiled or bloody clothes, bedding or towels in hot, soapy water. Add chlorine bleach if possible.
Try to bathe the sick person everyday. Wash him or her with a cloth or sponge soaked in lukewarm water if he is too sick to get out of bed.
Listen to the patient and respond to his needs. Talk to your local health care worker if you need advice. Make sure the patient takes his medication and visits the hospital or local health centre for check‑ups.
Severe pain in the chest, hands, feet or in the form of headaches is very common. Sores and ulcers in the mouth or around the genitals and anus can also be very painful. Give painkillers as prescribed by the health worker before the pain gets very bad, and regularly while the pain lasts.
You can also put a cool, clean moist cloth over the painful site, pour clean water over it, or massage it gently with oil or vaseline. Ask the sick person to breathe deeply and regularly. This can help the person relax. Rub the buttocks, elbows, heels and back regularly so blood circulates, and to prevent pressure sores.
Diarrhea can be a major problem for a person living with HIV. Sometimes it lasts for several months. The stools may be watery, or foul smelling with pus. The person may feel depressed, sometimes refusing to eat or drink for fear of making diarrhea worse. Encourage him to eat frequent, small and nutritious meals.
Select good food. Give the patient what he or she can easily digest. The patient should have a balanced diet – foods that are locally available and affordable. Prepare the food to suit the patient’s condition. For example, a patient with sores in the mouth needs lots of soup or juices.
Give plenty of fluids to prevent dehydration. Give water, unsweetened fruit juice, soup, rice water or weak tea. If the patient is vomiting, give the fluids in small amounts but more frequently. Fluids containing too much sugar can make diarrhea worse. If the person is feeling thirsty or has a dry tongue, give him a salt and sugar solution. For one glass of water, add one teaspoon sugar and a pinch of salt.
Change bed sheets frequently. Protect the mattress or blankets with a plastic cover. Open windows to allow good ventilation and to get rid of any odour. Soak spoiled linen in solution made with one cup bleach and nine cups water for twenty minutes before washing them.
Many patients with AIDS get confused. They may not be aware of what is happening around them. They may be forgetful, unable to think clearly, or move clumsily. They may be aware that they are confused now and then, and this can be very upsetting.
A person who is confused needs constant attention and reassurance. Remind the patient of who and where they are. Speak slowly and calmly. Remove all dangerous objects from their reach.
People with AIDS can develop severe skin abscesses (an infection that forms a sac of pus under the skin) and ulcers which are large open sores. These conditions can affect the rest of the body, making the patient feverish. To reduce the fever, remove unnecessary blankets. Clean the ulcers regularly with antiseptic or salt solution and bandage the sores. To make the salt solution, add one teaspoon of salt to a cup of water.
If the sick person has to stay in bed, move his or her legs and arms gently several times a day, and turn the person’s body every few hours to prevent bed sores.
Be there to comfort and care for your friend or relative. Be honest, patient and try to be positive. Take care of yourself; this work is often physically and mentally tiring. Talk to other people in your community. Ask for help if you need it. Accept the help of others if they offer.
“Caring for People who are Dying at Home”, Dr. Elly Katabira, AIDS ACTION. Appropriate Health Resources and Technologies Action Group, AHRTAG, 29‑35 Farringdon Road, London EC1M 3JB, UK.
Where There is no Doctor, David Werner with Carol Thuman and Jane Maxwell, Revised English Edition, May 1992, 446 pages. The Hesperian Foundation, Palo Alto, CA 94302, USA.