Ministry of Social Justice and Empowerment had constituted an experts committee to formulate uniform acceptable standards for home care and hospices for senior citizens.
While this is definitely a positive step however in my personal opinion the guidelines need more elaboration.
Home care and palliative / hospice care are different type of care offerings which should ideally have different sets of standards and guidelines. Clubbing of different types of care services can create confusion amongst service providers and increase chances of non-adherence.
The recommendations seems to be very generic in nature which can create loopholes in the system and service delivery.
Some of the points recommend by the committee are listed below and may need more deliberation;
Rule 1.4: Basic home care services shall be provided by care providers including but not limited to geriatric animators (trained by NISD or an equivalent organization), counsellor, physiotherapist, dietician and volunteers.
If this rule has to be followed to the word, then 95% of the home care providers will not qualify.
Rule 1.7.1: Each district shall form a group of 5 to 6 trained volunteers from the community to make 2 to 3 home visits per week within a 20 kilometres radius area.
Volunteering in India has not been a very successful and practical model, expecting district level volunteering program to succeed as an ongoing activity may be expecting too much.
Rule 3.3: Home care team shall comprise a Counsellor possessing MSc/MPhil Clinical Psychology with one year experience in palliative care.
This rule is probably difficult to adhere to because a lot of service providers are charitable organisations who don’t have the bandwidth to hire professionally qualified people.
Rule 3.6: Home care team shall comprise a Geriatric Animator possessing a Certificate of having passed Geriatric Animator’s course from National Institute of Social Defense or an equivalent organization.
Similar to rule no 1.4 this rule can become a problem because most of the home care providers in India are mom and pop stores who are probably not even aware of a word called Geriatric Animator. The equivalent organizations to NISD should be mentioned to facilitate smooth implementation rather than making it debatable.
To summarise my views, I feel the document should have also talked about issues like scope of care givers i.e. job profile of care givers, nurses, paramedic etc. The question about who is eligible to give medicines or an injection as part of home care service should be clearly defined.
Secondly a sample service agreement should have been shared which documents things like indemnity for service providers, actions against possible abuse, dispute resolution, legal liabilities, complaint escalation etc.
The document Home Care Standards & Guidelines can be downloaded here or can be accessed below.