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I hope I find you in good health. HIV/AIDS has turned a lot of lay people
into professional health care workers. A lot of relatives and loved ones are discharged
from hospitals for 'home based care'. Meanwhile a lot of individuals who are supposed
to be doing the caring haven't got the slightest clue how to go about it. This
can bring a lot of distress both on the patient and the caregiver. A reader of
this column requested that I deal with the practical issues of caring for people
with AIDS. In particular they wanted to know how to deal with symptoms of nausea
and heartburn or feeling bloated. I hope this article will help a lot of heroes
out there doing the best they can to care for their loved ones.
People with
AIDS should take care of themselves as much as they can. They need to be and feel
as independent as possible. They need to control their schedules, make their decisions
and do what they want to do as much as they are able. They should develop their
own exercise programme and eating plan. In addition to regular visits to the clinic
or doctor, many people living with AIDS should work at staying healthy by eating
properly, sleeping regularly, doing physical exercises and praying or meditating.
If the person you are caring for finds that something helps them, encourage them
to keep it up. Well balanced good tasting meals help people feel good, give them
energy and help their body fight illness. Everyone should try and keep the
patient comfortable by respecting their independence and privacy. Give them control
as much as possible. Ask to enter their room, ask for permission to sit with them
etc. Ask them what you can do to make them comfortable. Many people feel shy about
asking for help, especially help with things like using the toilet, bathing, shaving,
eating and dressing. Try to keep the home clean and bright. Let the patient stay
in a room near the bathroom. Leave tissues, towels, a bin, extra blankets and
other things needed close by so they can be reached from the bed or chair. If
the patient has to spend most of the time in bed be sure to help them change position
often. A nurse can show you how to help someone move from a bed to chair without
hurting yourself or him or her. If possible a person with AIDS should get
out of bed as often as they can, this helps prevent stiff joints, bedsores and
pneumonia. Bedsores or other broken skin can be serious problems for the patient.
In addition to changing position in bed, to keep skin healthy, put extra-soft
material under the person, keep the sheets dry and free from wrinkles. Massage
the back and other parts of the body like the hips, elbows and ankles that press
down on bed. If the patient is having trouble breathing, sitting them up
may help. Raise the head by using extra pillows. If it's a severe breathing problem
they need to see a doctor. It is essential to provide emotional support,
keep them involved in their care and do not do everything for them and make all
decisions. Include the patient in the household and part of the normal talk. Listening,
trying to understand, showing you care and helping them work through their emotions
is a big part of home care. Friends and relatives should be encouraged to visit.
Touch them, hug them and hold their hands to show that you care. Go out together,
attend social events, shopping, walking or just sitting in the sun and breathing
fresh air. HIV/AIDS can sometimes make it difficult to eat. Some foods,
which were eaten without a problem before, may now be difficult to eat or digest.
Infections in the mouth cause sores, which hurt when eating ,or tiredness may
prevent eating. Anxiety and worry about food and nutrition can also be a problem
even when feeling well. Monotonous meals, noxious smells and odours can
contribute a great deal to loss of appetite. There are certain things, which help
people living with HIV/AIDS to eat and feel better when they have these problems. For
most people living with HIV, nausea is a temporary condition. Infections and medication
can cause nausea. The patient has to wait till they feel better before taking
a large meal, but its important not to miss out on their food intake. The smell
of cooking foods with strong aromas such as cabbage, guru/ matumbu or onions must
be avoided. They should eat smaller meals more frequently throughout the day.
Drink liquids between meals. Eat meals separately from liquids with 1-2 hour intervals.
They should try to eat more cold foods, they are usually tolerated better. Sip
cool beverages. Clear fruit juices, mahewu, sour milk, herbal teas and cold drink
will be tolerated better. Dry toast, crackers, munya and cereal help to relieve
the nausea. Patients should choose foods that are not very greasy, spicy and very
sweet. They should avoid lying down immediately after eating. Heartburn or
feeling bloated can be a problem in HIV/AIDS. Gas-forming foods such as beans,
onion, cabbage, broccoli, cauliflower and carbonated drinks should be avoided.
spicy foods, curries and pepper should be avoided. Avoid alcohol, coffee, peppermint
and chocolate. Also avoid cigarettes. All these foods will make the heartburn
worse.
Remember HIV/AIDS is an illness you don't have to be ashamed of.
So talk about it with your partner and family.Till next week, take care of
yourself and each other.
Dr P. Chimedza
is a medical practitioner with a special interest in HIV and AIDS. Information
for this article was researched from different medical textbooks, medical journals
and other medical information sources for which this author hereby acknowledges.
This column is kindly sponsored by Generation Health. For further information
on this topic and suggestions on future topics for discussion you can mail him
on pchimedza@hotmail.com.
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