Discovery Home Health service provides vital care and comfort during Paula Rhodes' final months of life

In a letter emailed by Claire Yeun to Discovery Health Medical Scheme (DHMS) after her mom, Paula Rhodes passed away in August 2024, Claire writes: "Sister Maanda Muthaphuli has truly gone above and beyond, and she did it with so much gentle compassion."
In her final months, Paula who had chronic obstructive pulmonary disease (COPD) and dementia, received support from the Discovery Home Health service, which included scheduled visits from nurse Sr Maanda, who specialises in palliative care.

Paula's condition worsens, and she struggles to care for herself

"Mom was strong-willed and fiercely independent," says Claire. "She had worked from a young age to support her parents and brother, and only stopped working when she turned 72. In her final years, mom was living in a cottage on a farm in Midvaal - a rural area in the south of Gauteng." "In December 2020, at the age of 76, mom was diagnosed with COPD and eventually had to rely on an oxygen machine. She didn't like using the oxygen machine because it affected her independence by limiting her movement. In the four years before her passing, mom's overall condition deteriorated due to her COPD."

• COPD is a lung condition caused by damage to the lungs. The damage causes inflammation inside the airways, limiting airflow into and out of the lungs. This can make it difficult to get enough oxygen into the blood stream, leading to low oxygen levels, which can be life-threatening. Symptoms of COPD include trouble breathing, coughing and wheezing.

"In 2023 we realised that mom likely also had dementia, which was affecting her understanding of time and which also meant she was unable to look after herself properly. Mom wouldn't realise that she hadn't bathed or washed her hair for days, even weeks. She thought she had been driving to the shops to buy her own groceries, when in fact, I had been doing all the shopping and cooking for her." "Mom's dementia was never formally diagnosed. She couldn't deal with the concept of having a terminal illness like COPD, never mind dementia, and so she refused to go to healthcare providers to be assessed."

Desperate to get personalised care and added support for Paula, Claire contacts Discovery Health Medical Scheme

"By the beginning of 2024, mom was living with a friend on the farm and he was helping to look after her. But he struggled to keep up with her care needs."

"Desperate to get help for my mom, I phoned her medical aid, Discovery Health Medical Scheme. We were put in contact with Caroline Thabatha, the care co-ordinator of the Advanced Illness Benefit (AIB). I knew that mom being out on a farm would be a huge obstacle, but Caroline reassured me that they would be able to help mom. She was so helpful and compassionate. In February 2024, Caroline sent a palliative-registered GP and Sr Maanda (a palliative nurse) to assess mom and register her for the AIB and for Discovery Home Health. Initially, the GP and Sr Maanda would visit mom once a month. Soon they realised that mom needed more regular care and so they would come every second week."

• "The Advanced Illness Benefit provides palliative services to DHMS members who are terminally ill," explains Caroline. "The Benefit pays for care by a multidisciplinary healthcare team in the member's own home or in a hospice facility."

Compassionate Sr Maanda goes the extra mile for Paula

Claire explains how Sr Maanda treated and cared for her mom, Paula: "Sr Maanda had a calm presence. She understood and accepted that my mom wasn't easy to deal with. Sr Maanda and the GP were a compassionate team, who managed to strike a rapport with mom despite her nervousness and guarded attituded. Sr Maanda was always friendly, gentle and kind. She would ask mom how she was feeling or if she needed anything. She always asked mom's permission before she took her blood pressure or checked her vitals."

"In June 2024, I had to go back to the UK, where my siblings also live. Sr Maanda then started visiting my mom once a week. The logistics of getting a carer to go to the farm were almost impossible, so Sr Maanda offered to do a bed bath for mom during her visits even though I knew that this wasn't part of her duties. She was willing to go the extra mile for mom's care and comfort and for my peace of mind and she expected nothing in return."

Sr Maanda: "Over time, by being consistent and reliable, I earn their trust and make them feel at ease with me"

Sr Maanda speaks about the Home Health service and reflects on her time spent caring for Paula: "Home Health nursing plays a crucial role in bridging the gap between hospital treatment and independent living for patients. It provides personalised care in the comfort of a patient's home, supporting both their physical and emotional health."

"My role as a palliative nurse for Discovery Home Health is to empower patients to maintain their independence at home, educate them about their health conditions, and collaborate with family members to develop a comprehensive care and support plan. Through this approach, I aim to enhance their quality of life and foster a nurturing environment."

"Paula was a special case for me. I noticed Claire's anxiety regarding her mother's care, especially given the limited resources near the farm. I assured Claire that I would provide the necessary support when she returned to the UK. Paula was a challenging patient, but I was determined to offer her the care and understanding she needed."

"When dealing with patients who may be difficult or nervous, I focus on building trust through consistency and empathy. I make sure to listen actively to their concerns and respect their feelings. I involve them in their care decisions and give them a sense of control. Over time, by being consistent and reliable, I earn their trust and make them feel at ease with me."

Sr Maanda provides reassurance and guidance in Paula's final moments

"In August 2024, mom developed a chest infection and she became very ill, going in and out of consciousness," says Claire. "Sr Maanda was the one driving mom's care when she needed it most and that was so reassuring to us. She set up a WhatsApp group between myself and my siblings so that communication was instant and we could make decisions immediately."

"Mom was nearing the end and that was scary for mom, for me and my siblings, and for mom's friend who'd been trying to care for her. But Sr Maanda assessed the situation confidently, and was decisive and honest. My mom's condition deteriorated quickly, and Sr Maanda ordered and administered medicine to keep mom comfortable and pain free. Through the AIB, Sr Maanda arranged for a nurse carer to stay with my mom 24-7 in her final days so that she wasn't alone for a minute. Sr Maanda was there when my mother passed away. She made sure that we had called an ambulance and arranged an undertaker."

"Access to Discovery Home Health gave us the best option possible for mom and for all of us. Using this service meant that mom could stay in her own home in her final months surrounded by nature, her pets, and her friend. The Home Health team never forced anything on my mom or on us. All decisions were made in consultation with us, with consent and no judgement."