Home palliative care for a terminal stage cancer patient--a view point of autonomy support

• Published in: Gan to kagaku ryoho Vol. 35 Suppl 1; p. 94
• Main Author: Oiwa, Takashi
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.12.2008
• Subjects: Analgesics, Opioid - therapeutic use; Home Care Services; Humans; Morphine - therapeutic use; Neoplasms - complications; Neoplasms - psychology; Pain - drug therapy; Pain - etiology; Pain - psychology; Palliative Care; Personal Autonomy; Terminal Care
• ISSN: 0385-0684

To recuperate from terminal stage cancer at one's dear old home is like a patient spending his time all day long with the family. Therefore, it is necessary for a patient to know his state of well being, and to comprehend how to cope with the expected change in cancer stages. In other words, the patient has to make his own decision as to what he wants to be cared for in the homecare environment, and he should provide information to the family and to caregivers. The author expresses such kind of a relationship as autonomy support, and it is an important viewpoint of home palliative care. Moreover, the idea of autonomy support was effective as well as relieving a severe pain of the disease from the patient. In our case for example, we experienced not only the amount of narcotic usage to control pain has decreased but the increase in narcotic amount at the near death period has also declined. In addition, we compared a home palliative care to a home recuperation of the senior citizen. As a result, the followings were emphasized: 1) In order to improve in the quality of home palliative care, it is important to catch the difference in subtle changes between the cancer patient and the senior citizen. 2) To note the problem of the sense of loss related to the welfare tools introduction. In this article, the problem of the cancer end stage caring was compared with the senior citizen homecare, and found that an autonomous support is clearly important.