rehabilitation
Since 1996, antiretroviral drugs (ARVs) have revolutionised the treatment of HIV+AIDS, although a cure still remains a long way off. We have seen our focus shift from terminal and respite care to rehabilitation both in the UK and Africa.
In the UK we provide the UK's only specialist unit for men and women with HIV-related brain impairment (HRBI). Symptoms of HRBI include poor concentration, loss of co-ordination and speech difficulties. This often renders individuals unable to perform daily living tasks such as cooking, washing, shopping or crossing the road
As well as addressing a rise in HIV related brain impairment, we are responding to multiple other needs. These include side-effects from ARV drug therapy, control of distressing symptoms and serious psychological, emotional and mental health issues, late diagnosis with opportunistic infections.
To deal with this, whether in Africa or UK, interdisciplinary work is essential with staff skilled in the following areas
• medical
• psychiatric, counselling and social care
• rehabilitation
• occupational therapy
• physiotherapy
• massage therapy
• aromatherapy
• speech and language therapy
• dietetics
• chaplaincy
medical
Our medical team includes both doctors and nurses who are experts in the field of HIV+AIDS. Our nurses are trained in both general health and mental health care, allowing them tend to the whole person and manage the chronic, complex, diverse and multiple conditions that our patients face.
Psychiatric counselling and social care
Some of our patients come to Mildmay with pre-existing mental health problems. These can have an impact on their health and HIV status, for example, patients with mental health problems may find it difficult to adhere to medication. Others have difficulty coming to terms with their HIV status, have suffered from stigma and prejudice and find it difficult to cope. These, and many other problems, require the emotional, psychosocial and psychological support provided by our psychiatric, counselling and social care team.
Rehabilitation
Rehabilitation assistants play a vital role in helping to rehabilitate our patients and clients in order to maximise their potential and enabling them to achieve as much independence as possible. The assistants participate in all aspects of assessment, treatment, personal care and evaluation of all patients right up to discharge – even organising appropriate accommodation and facilities, (including connection to gas supply, cooking utensils and furniture) for when they return independent living.
occupational therapy
HIV+AIDS have stripped many patients of the everyday skills that we can so easily take for granted. But by breaking these down into manageable steps with the support of our occupational therapists - skills can be painstakingly relearnt and independence regained.
For many of our patients and clients, returning to their previous occupations isn’t possible but there is still the need to provide for themselves and their families. Our occupational therapists can help these people learn new skills and secure a better future for themselves.
Physiotherapy
Physiotherapy helps the client perform daily living tasks and enables them to develop the skills they need to live independent, satisfying, and productive lives. Physiotherapy is concerned with human function and movement and can address such problems as pain, muscle weakness, joint stiffness and damage to the nervous system, all of which can make it difficult to walk.
The physiotherapist will assess and identify a patient’s difficulties and needs and arrange a tailored rehabilitation programme. This can include activities to strengthen muscles, develop coordination and balance, increase the range of movement, relieve pain and help the patient get back on their feet.
aroma/massage therapy
This is a good example of Mildmay’s holistic approach as massage can not only treat the physical symptoms associated with HIV+AIDS but it is also a great comfort and source of relaxation for the patient. For patients who have experienced the stigma and isolation associated with HIV, the act of touch can be as beneficial as the sense of well being that massage can provide. What’s more, evidence shows that massage can increase CD4 T (immune) cells and thus assist in increasing patients’ immunity.
Speech and language therapy
Many of our patients lost their ability to speak and communicate through traditional means. Be it due to HIV related brain impairment or damage to the mouth itself, losing the ability to speak can add to the sense of isolation and distress. Our speech and language therapists can literally give a person their voice back.
What’s more, due to their illness, some patients have lost muscle usage in their mouths and can find the action of swallowing difficult or impossible. Our speech and language therapists can work with these patients, providing exercise programmes and massage techniques that allow the muscles to relearn this vital skill.
dietetics
The role of the dietitian goes beyond ensuring that patients’ nutritional needs are met, it also involves working with them to ensure they understand how their diet is central to their general well being
Poor nutrition has an adverse effect on health such as lowered immunity, slower healing of wounds, depression, muscle weakness, and respiratory failure. Poor appetite and/or nutritional intake are a common problem for most of our patients. Providing nutritious meals is therefore an essential part of Mildmay’s services for people living with HIV+AIDS.
Chaplaincy
Chaplaincy staff aim to meet the spiritual needs of Mildmay’s patients, their loved ones, volunteers and staff - pastoral care is offered to all. For patients and clients, this may range from befriending through prayer, biblical reflection and reading to the exploration of issues such as death, loss, sexuality, the family, isolation, trauma, stigma and dislocation. For some patients, faith has been the only thing that has pulled them through the difficult times. For others, their beliefs have been tested and they may even have a difficult relationship with the church, many come to us with no faith at all. Whatever the scenario, our chaplains are here to help them explore their feelings and offer them the support they have otherwise been lacking.