When illness strikes and there is no insurance

Health insurance is expensive and not everyone can afford to have one. Indeed, the majority of Kenyans are not insured. But whether you are insured or not, one thing is sure, you or a family member will at some point require health care services. We prepare you for that eventuality.

If you don’t have an insurance cover, ensure you keep some money aside for any eventuality and not wait until a crisis is at hand before you act. If you or a member of your family becomes seriously ill and you don’t have an insurance cover, the first thing you do is set up a budget and care plan. First, find out exactly what the medical treatment will be. See how much of this can be provided in cheaper government facilities and which treatments you will need to seek in private hospitals and clinics. For example, some government facilities may not have diagnostic equipment such as MRI or CT scan and you may be sent to private facilities.

Next, develop a strategy to support the sick individual with other members of your family. Sometimes moral support is more important than even financial because when the sick person knows he is not alone, he is better able to face what lies ahead. Get together with other family members to offer prayers and any other support needed by the sick person.  For instance, you many have connections with doctors or organisations that can offer quality treatment for less or even for free.

Review your overall financial position in case you need to consider dipping into savings, taking a loan, selling an asset or asking friends and family members to help. This is not a decision you want to rush into during the care process and its best to give yourself time to investigate options. It is best if you can form a committee of trusted family members and friends to help you make the best decisions.

Even though you may have money to cover treatment, there are extra costs to consider, including transportation back and forth to the hospital, the cost of food for those coming to visit the patient or a special diet that the patient may need and, of course, other caregiving costs. Where cancer, organ problems or a transplant is involved, large-scale tests, including scans, X-rays, CT scans, echocardiograms, extensive lab works, clinical visits, dialysis and the like can cost a lot of money, in addition to the actual treatment. So you will need to take all these into consideration when working out a budget and planning funding sources.

Nurture emotions…

Set out a communication strategy on when to share information with family and friends when an illness strikes. Sometimes its best that you or the patient first accept their condition and deal with the issues before you let friends and family know, of course with the exception of those very close to you. The reaction of friends and relatives is often overwhelming and you may not know how to deal with this added pressure and stress, especially when everyone wants to know all the details. Prepare yourself also to cope with the patient’s own grieving period over their diagnosis or your own. Seek professional and spiritual support. It is best to use professional counselors who are well trained to handle difficult situations. Your religious community and congregation come in handy to offer spiritual support through prayers, as well as financial support where needed. Use experts to educate you on mood swings and changing behaviors related to the illness.

Tap all available resources and seek others who have survived similar situations or whose families have shared the experience. Accept and encourage support from genuine outsiders and organisations. There is a lot of information available on the Internet and you could use this resource to arm yourself with knowledge, which you will need to deal with the illness and also discuss it intelligently with health care providers.

Get organised…

If there are multiple family members engaged in the care or support of the individual, organise commitments on charts with reminders and positive reinforcements. Caregiving can be enjoyable and bring you closer together if it’s well organised, but it can also tear you apart, especially if you are not working towards a common goal. It is best that individuals take on responsibilities in areas where their strengths lie.  Share calendars and responsibilities in a manner that can be assessed by friends and family, as this will allow ease of communication, avoid duplication and take stress off the family.

If the patient is seriously ill, arrange for medical powers of attorney to authorise a family member make crucial decisions on treatment and care. Also ensure the patient has a will and get ready to manage the patient’s affairs in the best way possible. Put together the patients’ medical history, which can be shared with experts, caregivers and facilities.

Be tenacious…

Tap into your drive at work to accomplish your work goals when you’re the caregiver so that your work does not suffer. Do not ignore your work to devote yourself fully to the patient, as you will need it to pay the bills. Get friends and family to hold fort for you when you are at work. If the patient is seriously ill or is suffering from injury, he may require an adjustable bed, an extra nurse to help with bathing, feeding and other needs. Rest assured, it will often take every negotiating skill you know to get the treatment and care you or your patient desires. Review methods to improve day-to-day life experiences of your loved one and seek help when it’s necessary. It can be simple tasks like bringing prayers for the patient, singing for them, just keeping them company, or ensuring their children and close friends and family visit often.

Family and friends may disagree or criticise you over a patient’s care. For example, parents and relatives of your spouse may conclude, for no good reason, that you are not offering their child the best care or support. Remember their opinion is just an opinion and as long as you are sure you are getting the best medical care for them within available resources, just learn to ignore them or accommodate them if they genuinely want to help. Joining an association that focuses on a patients’ condition, such as spinal cord injury patients or the terminally ill, may support you. It is often empowering to focus your leadership skills toward the issue. It also can keep you abreast of new treatments, top specialists, and developments in the medical field. Sharing with others in your situation also reminds you that you are not alone and this is encouraging and makes your burden easier to carry.

Caregiving consumes extensive emotional and physical energy. It is important to schedule self-care and exercise into your regime on a calendar. Do not ignore your personal well being as you will not be in a position to take care of another person when you are not in good emotional and physical health. Make a twenty-minute commitment to take exercise, meditate, enjoy a relaxing bath, or a positive companion. Also, visit the hairdresser; go for a massage or a steam and sauna bath. Keep positive energy as this will permeate to the patient and bring in a quick recovery. Whatever happens don’t panic. Always remain cool and calculated especially when with the patient. He is the one who is sick, not you.

 Published in October 2013 issue