Health Home Care at your Doorstep

During the pandemic, the hospitals were seen overwhelmed with the constant flow of patients, increasing risk for the transfer of the disease. But, there are people with underlying health issues, who need health care on the regular basis. Lifeline Health Home Care can help in such situations. They are home healthcare service providers who provide consultation for isolation, sample collection, and tests, along with physiotherapy services. They are here for the easy access of essential health for all, says Dr. Bipu Dhakal, Chairman of Lifeline Health Home Care. The concept of Lifeline Health Home Care basically stands on the following three grounds:
a. Easy access of essential health to all
b. Minimization of medical delay due to medical unawareness
c. Holistic approach on patient care through teamwork
To achieve the above-mentioned objectives, they have established different departments:

a. Team of doctors: The team comprises of enthusiastic and well-trained registered medical practitioners, who provide consultations and perform basic medical/surgical procedures at the doorstep of patients and are available 24/7 to serve humanity. The head of the team ensures that the doctors are up-to-date and competent for quality healthcare, and plans for regular CMEs and training programs so as to uplift their skills and knowledge. This department also looks after nutritionists and clinical psychologists, who provide support to doctors for the treatment of patients.

b. Department of Nursing: It looks after and manages nurses, HAs, CMAs, ANMs and trained caregivers to provide quality nursing care at home under the supervision of doctors, and ensure that all essential nursing care is provided. This department also looks after the skills and knowledge requirements of the staff and appoints suitable staff as per patient’s need and condition. This department provides 24-hour, 12-hour, 8-hour, and on-call nursing service as per the patient’s demand. Recently, this department is preparing for maternal, neonate, and infant healthcare to introduce quality home-based antenatal and postnatal care for mothers, and also quality neonate and infant care, so as to reduce perinatal, maternal, neonatal, and infant morbidity and mortality.

c. Department of Physiotherapy: It provides home-based physiotherapy by highly qualified physiotherapists, with the aid of portable and scientific machines essential for quality physiotherapy services. This department also studies the patient’s condition and appoints physiotherapist accordingly. Both general physiotherapy and specialized physiotherapy services like neuro-physiotherapy and chest physiotherapy (for COVID, COPD, and other patients with respiratory disease), spinal physiotherapy, etc. are being provided by the department.

d. Department of Medical and Surgical Equipment: Many patients require various clinical equipment for short-term use, so this department was established to provide medical/surgical equipment like oxygen concentrators, BiPAP machines, suction machines, hospital beds, IV stands, infusion pumps, syringe pumps, cardiac monitors, etc. on a rental basis, with provision of purchase facility, if needed.

e. Pathology and Biochemistry Department: Basically, this department is commonly understood as a medical lab by the general people. This department is established for investigation of diseases and aid in diagnosis. Similarly, the institution also has pharmacy, logistics and transportation, public health, and finance and IT departments.

Home isolation program for COVID-19-positive patients requires teamwork, where all departments work together to give support to patients who are in home isolation by providing consultation, sample collection for essential laboratory tests, 24-hour nursing service, rental service of oxygen cylinder and concentrator machine, medicine delivery, COVID-directed physiotherapy for faster recovery, and transportation of patients to hospital in case of illness severity and high oxygen demand.
During the first wave of COVID in Kathmandu, every day after his hectic duty in COVID ICU, Dr. Dhakal started serving his neighbors in their homes. It was really a havoc situation, when there was no oxygen available, no beds available in hospitals, and no doctors, as everyone was busy. He treated around 500 patients at home during the first wave, among whom 100 needed oxygen supplementation, but it was tough to arrange oxygen at that time. With the help of Lifeline Care Pvt. Ltd., who agreed to provide oxygen concentrators to him on rent, he began providing the same to needy patients. And, the recovery rate of patients treated by him at home was good. This made him realize that home services gave patients:
a. Early doctor consultation, as it was easy for patients to consult doctors at home, compared to visiting hospitals, and it was helpful in identifying symptoms in time.
b. Easy availability of essential nutrition at home.
c. Reduction of cross infection and antibiotics-resistant hospital acquired infection.
d. Improved psychology of patients.

Along with his involvement, he got attached with one of the home care agencies and started serving patients with other illnesses, along with COVID, during the first wave. While being bonded with that agency, he saw newer aspects of health that he had found missing in hospital care. He felt that his service was providing greater relief to elderly and paralyzed patients, who were not able to take care of themselves and had difficulty visiting hospitals and going through different procedures. Lifeline Health Home Care visited such patients, assessed their condition, advised them, and prescribed medications. And, with a holistic approach, it was easy for them to identify contributing factors for health, such as cultural and socio-structural aspects.

In home care, Dr. Dhakal was able to move beyond the classical concept of disease treatment, that is, “Pill for every Ill”. He started addressing nutritional, hygienic, psychological, and recreational aspects of treatment; in other words, he learned to treat the patient and not the disease. Likewise, in many instances, he found that home care reduced the cost of health services, such as transportation and bed charges, and minor illnesses could be treated at home. With this spirit, he served around 1500 COVID-positive patients at home during the second wave, among whom 500 needed oxygen supplementation, which was so challenging at that time. Even though Lifeline Health Home Care was not established at that time, he and his team (namely, Dr. Pujan Shrestha and Dr. Manish Yadav) worked together and successfully served all the patients. The end of the second wave was a really happy and satisfying moment for them, as their success rate was nearly 100% (only two patients required mechanical ventilation, and sadly, both of them didn’t make it).

Initially, he worked with an agency, but he had some differences with them. He believed in serving patients and bringing a smile of satisfaction on their faces, so he left his association with the agency, and along with two doctors who were with him during the pandemic and were members of Lifeline Care Pvt. Ltd., who had helped him during the first wave, they established Lifeline Health Home Care Pvt. Ltd.

He has designed it in such a way as to regard patient care as its foremost responsibility, and he says, “Firstly as a doctor, and also as the chairman of this company, my every step will be focused on quality healthcare delivery at home.”

The major motivation for establishment of Lifeline Health Home Care was to provide a holistic approach to healthcare, where patients receive quality healthcare at a reasonable and affordable price. According to the doctor, cost in most of the instances is a relative term. He says, “In many instances, what one prioritizes matters; if a person is aware of the quality of life that good health can provide, he will find the cost of services affordable, relative to the quality offered.”
He adds, “On the first hand, an individual should be conscious towards his/her health habits. On the other hand, considering the GDP and HDI of our country, many families might really find it hard to bear the cost for health despite our efforts to reduce the cost of the services. To make it affordable to all, we have segregated the level of our services. For those who can afford and require maximal health facilities, we have one kind of package; likewise, for middle class families, we have another package. Whatever be the package, basic healthcare is ensured.”

Home healthcare service is a relatively new concept for a country like Nepal. Even before the current pandemic, very few families were aware about the service of Lifeline Health Home Care. Now, after the first and second wave of COVID, many people have heard about them, with some currently receiving the benefit of this service. At preesent, Lifeline Health Home Care is providing nursing service to 18-20 families, and in the past three months, they have provided consultation to over 100 patients, home physiotherapy service to 30 patients, home lab services to more than 500 patients, and rental equipment service to 30 patients, which shows home healthcare is a sustainable project in Nepal, and the only thing lacking is awareness of health home care in the general population, as well as the seriousness of health home care agencies. Training their staff has been an integral part of their service, and this is important to gain the trust of patients. Taking this into account, his department frequently organizes CMEs, BLS training programs, and symposiums and seminars to uplift skills and knowledge of their staff, and to improve the quality of healthcare service.

Healthcare at home could be the future of the healthcare system. It is now well understood from the experience of the current pandemic that hospital-based health care systems won’t be enough during public health emergencies. In such cases, including general cases, home care is an effective and easily accessible healthcare alternative to hospital-based healthcare. Similarly, long-term care to elderly and paralyzed patients, patients under palliative care, and patients requiring rehabilitation care is only possible in a home care setting, as home care is based on three basic principles—reinstitution into daily activities, hygiene and nutrition, and continuation of essential medication with compliance, which cannot be addressed by hospital-based care. Also, in this era of technology and globalization, people have become very ambitious and are dragging themselves so much into a busy life schedule that they have not time to take care of their parents.
If a family member is sick, the working member loses his/her productivity because he/she is bound to spend his/her valuable time for that member. In such instances, a home healthcare provider can look after that member. Likewise, this could be very helpful to children who are settled abroad and are unable to see their parents in person. In such cases, a home care organization can send a medical team for the treatment, and send their updates. With their proficient team members and rigorous work ethic, aong with the gratitude of the people they have treated, Dr. Dhakal feels that Lifeline Health Home Care will be well established soon and continue to provide better health care delivery systems in Nepal.

Dr. Dhakal initially had a vision of a society where everyone has easy access to health, and where people don’t die from medical delays and unawareness, and he saw the only possibility for fulfilment of his dream is through a service like Lifeline Health Home Care. Similarly, the doctor is equally concerned about healthcare providers, who he thinks should not be burdened with too heavy a workload, and that work and pay balance has to be there. In future, he is hopeful of bringing health services accessible to all socio-economic groups of people and continuing to serve humanity.

For further details, please contact:

Lifeline Health Home Care Pvt. Ltd.
Pulchowk, Lalitpur
01-5445084, 9801102740, 9801102742
Email id:- lifelinecarecd@gmail.com

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