Legal aspects are gradually becoming part and parcel of palliative care provision in Kenya. Caring for patients at the end of life stage is a task that requires not only the consideration of the patient as a whole but also an understanding of the social, family, economic, institutional and most recently legal circumstances that surround patient care.
Kenya Hospices and Palliative Care Association(KEHPCA) started a legal aspects programme in conjunction with a local non-profit organization,KELIN, to be implemented in hospices around the country. Its purpose being to provide legal capacity to health care professionals and non-health care workers, lawyers and paralegals offering care and support to patients and family members facing problems associated with life threatening illnesses. Among the psycho social needs of the patient are legal concerns which include delegation of decision making and power of attorney; property inheritance; how to make a will; patient rights and responsibilities; and palliative care as a human rights issue obtained from the right to health care.
The idea of integrating legal aspects into palliative care provision was mooted in 2010 and implementation carried out in the same year. Nyeri Hospice implemented and integrated the legal work in the same year. Five years down the line, the project has been a great success in a region where land and property inheritance are a major issue for locals to contend with. The hospice provides services to patients from Nyeri County and the neighbouring counties of Kirinyaga,Nyandarua, Laikipia, and some areas of Murang’a.
“We integrate legal aspects when we carry out home visits to provide care to the patients who cannot make it to the hospice,” says Saraphina Gichohi, the Chief Executive of Nyeri Hospice.
The hospice is now also the first to pilot a data collection tool for patients who require legal aid services during the clinics that are held every third Wednesday of the month. The tool will allow paralegals to adequately document and address the issues that patients may have in regard to legal matters. Details such as occupation; physical address; health condition; assets owned; legal issue assessment; and institutions engaged (religious, social or governmental) will be taken down so as to function as a reference point for the families, paralegals and relevant authorities to facilitate smooth transition in the unfortunate event that they lose a loved one.
Key issues addressed during Legal Aid clinics
At Nyeri Hospice, the top legal aspects that patients ask to be guided about include:-
Ø Writing a will
Ø Succession in businesses and companies
Ø Power of Attorney
Ø Patient and children’s rights
The two paralegals at the hospice, Mercy Owiti, a senior palliative care nurse and Johnson Ritho, a social worker provide assistance to patients on the days when legal aid clinics are held and are usually available for home visits. The hospice also invites an advocate who has made a commitment and provides pro-bono services during the legal clinics.
Challenges faced by the Hospice in Legal Aspects implementation
And like almost everything in life, the implementation of legal aspects programme at Nyeri Hospice has faced some challenges. These include but are not limited to:-
Ø An unstable internet connection
Ø Software to aid in data collection and storage
Ø Teething problems in the implementation of the data collection tool kit
Ø Human resource and equipment
Local partners including KEHPCA may soon come on board to support the hospice in smoothing out some of the above-mentioned challenges.
After Nyeri, the legal aspects project is targeted to be implemented in Nairobi, Meru and Coast hospices as part of the second phase.