Home care in Kathmandu starts with three facts the map will not show you: which floor the person sleeps on, who can open the gate after dark, and how long it takes to reach that ward at the hour you will actually need help. The National Statistics Office, reporting the 2021 census, places Kathmandu Metropolitan City among Nepal's most populous municipalities. Density is the practical problem. A short distance on a map can be a long visit once you add a lane, a stair, and the traffic.
This page is a planning guide for families. It is not a list of agencies, and it does not quote a price. The World Health Organization describes older people's care as something families often carry, with clinical tasks still belonging to trained people. Choosing a home nursing service is the question list. Use it before you accept "we cover all of Kathmandu" as an answer.
What to say before anyone comes
Give the ward, a landmark that is still there, and the floor. Many houses are walk-ups. A commode chair, an oxygen cylinder, or a wheelchair may not turn on a narrow stair. Say that on the phone. A plan written for a wide ground-floor room fails on the third floor of a brick house in an old lane, and it fails differently in a flat where the lift is out.
Say which adult is home at the visit time, and which adult is home at night. They are often not the same person. The afternoon helper may be at work by the time a bag needs emptying or a dressing starts to leak. Write both names next to the phone numbers.
Say the task in plain words. A catheter, a surgical dressing, a turn in bed, and company for an older parent are not one job. Understanding home nursing separates family care from skilled care. If you need both, say both, and ask which one the nurse will actually do.
Winter rooms in the valley are cold, and top floors in the warm months are hot. A person who stays in bed needs the sheet change and the wash planned so they are not left uncovered or shut in a still room. Mention the season. It changes what "a routine visit" should include.
The tasks families ask about
The clinical steps do not change because the house is in Kathmandu. The timing and the room do.
Urinary catheter care at home still means a closed system and a bag below the bladder, off the floor. In a small bathroom the bag is easy to set down "just for a minute." Agree the hook before the nurse leaves, and agree who empties it after they have gone.
Basic wound care at home follows the discharge note, not a shop near the hospital you will not pass again today. Ask which supplies must be in the house overnight. Saturday hours and a closed pharmacy are a city problem, not a reason to open a dressing early.
Dementia care at home is unsettled by noise, a changed lane, and a relative who is there only in the evening. New confusion still needs a clinician the same day. Do not explain it away as "the neighbourhood is too loud" and skip the call.
Palliative care at home needs a number that answers when the visiting nurse is in another ward. Traffic is not a reason to watch heavy bleeding or collapse until morning.
Physiotherapy at home often comes down to the stair. Ask the therapist to see it. "Are the stairs allowed, or is the toilet on this floor the only goal?" is a better question than "do you visit Kathmandu?"
If the person gets worse
Ask, before you need it, which hospital holds the record and how you get there from this ward in the evening. A private vehicle and an ambulance are both slower if nobody can describe the lane.
When to visit a doctor splits problems that can wait for a clinic from problems that cannot. If the treating team has named an emergency department, use that name when you call. Do not tour hospitals because the first one looks busy.
What a useful answer sounds like
A useful service names the nurse, the tasks, the hours they will not come, and the person you call instead. "We are nearby" is not that answer. Ask how they confirm the nurse's identity, and call the organisation back on a number you looked up yourself.
Households in Lalitpur, including Sanepa, often leave a Kathmandu hospital and go home across the Bagmati. That is a different municipality, with its own gate and its own evening traffic. Banepa is a hill town on the Araniko highway, not a Kathmandu ward. If the house is there, say so. A nurse planning for the valley centre will misjudge the ride.
Write the plan on one page: ward, floor, tasks, night contact, hospital, and the number for backup. Put it with the medicine list. The next relative on duty should not have to rebuild it from a chat thread.
