Established in 2006, RH exhibits innovations in making available home-based pediatric palliative care for the first time in the country and providing access to palliative care for those who otherwise cannot afford the care.
The clinical innovation - RH provides home-based palliative service which is still rare in Indonesia as palliative care service organizations mainly implement the concept of inpatient hospice care. From the beginning, RH incorporated both inpatient and homecare services. Over time, RH realized that the model of in-patient care was not well received by the patient’s family. Inpatient care is not consistent with Indonesian culture as it is every Indonesian’s dream to leave this world at home, surrounded by their beloved family. Responding to this, RH nurses visit their patients at their homes. RH patients receive health insurance from the government in the form of the National Community Health Insurance (Jamkesmas), the Poor Families Insurance (Gakin) or the Certificate of Being Unable to Provide for Oneself (SKTM).
RH is one of the first organizations outside the public health care system that receives patient referrals from public referral hospitals. It is through this successful networking with public hospitals and healthcare clinics, local NGOs and civil society actors that RH has been successful in promoting palliative care and its outreach to the poorest areas. This strategy has also allowed the optimal use of available resources to fill the gap in the healthcare system in Indonesia.
RH facilitates behavior change by providing quality health awareness and education for the doctors and nurses regarding pediatric palliative care and through training and field practice by experienced palliative care nurses. Also, the parents or caregivers of the patient are educated and trained on patient care, especially in the methods on how to reduce the patient’s feelings of pain, handle the symptoms that may arise, handle the side effects of medicines that the patient is taking, and giving physical and psychological support to the patient.
In the scope of their services, RH is also a palliative care training provider in Indonesia. With assistance from palliative care professionals from Singapore, visits from highly experienced palliative care nurses and nurse educators from Australia, the trainings are not only determined by the RH team, but also by the medical teams in Indonesia who are interested in palliative care.
RH services include nursing and administering of medical care to manage the patient’s pain and symptoms, visits by a doctor if the patient needs medical care, prescriptions for medicines and making available medical equipment and supplies for loan, such as wheelchairs and oxygen tanks. The facilities also provide guidance for the family on how to take care of their loved ones at home and help for the patient and their family in emotional and social aspects of facing death, sadness and loss. To allow for efficiency in travel time due to the huge coverage area, RH operates from three satellite areas, which are at the North Satellite (based in Plumpang), the West and Central Satellite (based in Slipi), and the South and East Satellite (based in Bintaro). One nurse is in charge of each satellite area and is responsible for every patient and all the activities in that coverage area.
There are many positive influences that came about as a result of RH. Key among these is the increasing number of medical professionals with better understanding of palliative care. Other benefits include the knowledge transfer from RH nurses to the patient’s parents (the caregivers) to empower them with the skills to manage the child’s pain and symptoms and to create greater awareness of the child’s emotional needs. This helps the patient’s family become more ready in facing the inevitable passing of the patient, they can be better judges of when to stop medicating the patient, as the doctor has stated that the patient is no longer curable, and they can focus their energy toward the psychological condition of the patient in facing death. In addition, the number of volunteers, social workers and organizations that have joined in engaging palliative care is increasing. This conveys the positive impact of palliative care services.
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