Therapeutic Case Management Techniques for HIV/AIDS Patients

Case management, sometimes referred to as care management, is a patient-focused process that coordinates existing services to the patients. Basically, case management aims to make the conditions of the HIV/AIDS patients better in order to prolong their lives. In addition, it makes patients address the many needs that are associated with their heath condition (Adrian & Martin, 2011). Therefore the case managers act like brokers in providing the services to the patients. This can be achieved through various techniques all of which serve the purpose of improving the health of the HIV/AIDS patients.

When the AIDS epidemic attacked in the 1980s, case management was applied to address the various needs for the clients and their families. Later in 1991, the National Commission on AIDS realized the value of case management as an intervention strategy for HIV-infected persons (Wilcox & Gallagher, 2011). It appreciated case management for achieving cost savings, reducing the number of patients being hospitalized, promoting order to the service delivery system, and for promoting patient satisfaction and quality of life. Today, there are many HIV/AIDS case management agencies that address specific vulnerable groups such as children and women, the unemployed, homeless, those who are chronically ill, and those with disabilities.

One of the therapeutic case management techniques that can be applied to the HIV/AIDS patients is by assisting them to gain access to health care facilities. Arrangements can be made by case managers to take patients to referral clinics or to physicians specializing in HIV. If this is not done some patients who may be disabled or critically ill may get worse due to lack of medication. In relation to this, case management can also be used to supply HIV/AIDS patients with more ARV medications or any other medication to prevent opportunistic diseases (Volberding & Deeks, 2010). This is specifically helpful to the patients who are at an advanced stage or are too weak even to walk on their own. In this case, case management managers arrange for transport or in extreme cases call the physicians to attend to the patients from their homes.

HIV/AIDS patients require eating healthy foods in order to boost their immune system for preventing them from the opportunistic diseases and infections. While put under case management, case managers are responsible for ensuring that the patients are served with healthy meals that meets all the necessary nutritional requirements. In essence, HIV/AIDS patients should be given a lot of fresh fruits and vegetables which are a source of vitamins. However, the patients are also advised to eat carbohydrates, proteins, and minerals to ensure their bodies have enough energy required for performing their daily activities. Due to the stigma associated with HIV/AIDS, the patients fear being seen in public and hence may not get a chance to buy foods (Salma & Graeme, 2009). In most cases, the patients come from poor backgrounds where it is challenging for them to avoid eating healthy meals when they are sick. Case management programs are mainly funded by donors and hence removing the financial burden from patients. It is also important to note that although some patients may afford eating healthy meals, they often get into denial and give up. As a result they end up eating unbalanced meals due to frustrations which makes their conditions worse.

Case management programs also assist HIV/AIDS patients to access other additional resources such as support groups, chemical dependency treatment facilities, legal assistance, vocational rehabilitation services, and mental health services. In the vocational rehabilitation facilities, specific conditions may be addressed by experts. For instance, HIV/AIDS patients at times result to drug abuse as an activity to keep them busy and to prevent them from getting depressed. There are also some cases where people contract HIV when they are already hooked into the habit of drug abuse. The implication is that such patients tend to continue with their drug abuse even when they are under case management programs. It is for this reason, that case managers may arrange vocational rehabilitation services where such patients are advised on how to stop the habit of drug abuse.

Some HIV/AIDS patients may be having mental illnesses especially if their status id advanced. Although it is not certain that these patients will be having mental illnesses, such conditions sometimes occur due to the trauma associated with HIV/AIDS. The fear of death may also contribute to deteriorating mental conditions. Case management managers have the responsibility to ensure that all the patients under case management are attended to if they have mental illnesses (Salma & Graeme, 2009). Usually, this is done by referring them to specialized treatment or to mental rehabilitation facilities if their condition becomes worse. Admittedly, it is challenging to manage HIV/AIDS when such patients are suffering from mental illnesses since they even refuse to take food and medication. This therapeutic case management technique ensures that patients’ needs are addressed accordingly in the same manner it is done to the patients without mental illnesses.

Another therapeutic case management technique used for the HIV/AIDS patients is developing supportive network where patients can rely on when needed. This supportive network can be through friends, families, or support groups. In the current society, HIV/AIDS patients continue being discriminated often due to the stigmatization of HIV. As a result, they lose their close friends and sometimes are abandoned by their close family members since they are seen as a burden. By establishing other relationships, case management plays a significant role in making the patients feel loved and appreciated. This appreciation is therapeutic and may at times prolong the lives of such patients since they remain happy and hence avoiding situations of mental depression.

Patients in case management may be provided with the necessary information that assists them in making informed health decisions. In this regard, HIV/AIDS patients are advised how to practice safe sex in order to avoid making their condition worse. For the safe sex, case management managers may distribute condoms to the patients and train them on the proper usage. In addition, the patients may be taught other risk reduction techniques such as sharing being faithful to their partners and avoiding prostitution (Allison, Henry, & Salata, 2012). All these are aimed at enhancing the patient’s behaviors instead of being careless because of their prevailing condition.

Another therapeutic case management technique for the HIV/AIDS patients is providing them with counseling services. In most cases, health condition for such patients is made worse by other factors such as depression, loneliness, discrimination, and rejection by families. Counseling plays a critical role in making the patients accept their situation and understand that they are not less of human beings since their lives are equally important (Volberding & Deeks, 2010). Consequently, the patients acquire positive attitude that is necessarily in prolonging their lives. In addition, they understand that live has meaning and that live should not stop because they have HIV/AIDS. Indeed, it is through such counseling service that the patients accept themselves and stop living in denial with some of them coming openly in public to declare their HIV status.

Generally, therapeutic case management techniques reduce the HIV stigma among the patients by making them more acceptable in the society and by making them appreciate their situation. In addition, case management promotes healthy eating habits among the HIV/AIDS patients and provides access to counseling services. Any technique adopted for case management should ideally contribute in promoting the wellness of the patients and subsequently enabling them to live positively in the society.

References

Adrian, P., & Martin, F. (2011). Diagnosis and Management of HIV Infection. British Journal of Hospital Medicine, 72 (3), 146-150.

Allison, W., Henry, G., & Salata, A. (2012). A Qualitative Description of Women’s HIV Self- Management Techniques, Context, Strategies and Considerations. Journal of the Association of Nurses in AIDS Care, 23 (4), 281-293.

Salma, F., & Graeme, M. (2009). Management of HIV/AIDS. Australian Family Physician, 38 (8), p. 573.

Volberding, A., & Deeks, S. (2010). Antiretroviral therapy and management of HIV infection, The Lancet, 376 (9734), 49-62.

Wilcox, R., & Gallagher, D. (2011). HIV Management: Returning to Primary Care Providers. Journal of Health Care for the Poor and Underserved, 22 (4), 1127-1130.