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London School of Tropical Medicine:Health Care Responsibility and Compassion-Visiting by the Housebound Patient Severely Affected by ME/CFS


Senior Member

Health Care Responsibility and Compassion-Visiting by the Housebound Patient Severely Affected by ME/CFS

Caroline Kingdon *, Dionysius Giotas, Luis Nacul and Eliana Lacerda

Department of Clinical Research, London School of Hygiene & Tropical Medicine,
Faculty of Infectious and Tropical Diseases, London WC1E 7HT, UK; dio.giotas@lshtm.ac.uk (D.G.);

luis.nacul@lshtm.ac.uk (L.N.); Eliana.Lacerda@lshtm.ac.uk (E.L.)
* Correspondence: caroline.kingdon@lshtm.ac.uk

Received: 9 June 2020; Accepted: 2 July 2020; Published: 4 July 2020

Abstract: Many people with severe Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) commonly receive no care from healthcare professionals, while some have become distanced from all statutory medical services. Paradoxically, it is often the most seriously ill and needy who are the most neglected by those responsible for their healthcare. Reasons for this include tensions around the complexity of making an accurate diagnosis in the absence of a biomarker, the bitter debate about the effectiveness of the few available treatments, and the very real stigma associated with the diagnosis. Illness severity often precludes attendance at healthcare facilities, and if an individual is well enough to be able to attend an appointment, the presentation will not be typical; by definition, patients who are severely affected are home-bound and often confined to bed. We argue that a holistic model, such as ‘‘Compassion in Practice’’, can help with planning appointments and caring for people severely affected by ME/CFS. We show how this can be used to frame meaningful interactions between the healthcare practitioners (HCPs) and the homebound patient.

Keywords: ME/CFS; severe ME/CFS; validation; engagement; health encounters; housebound;