ABSTRACT
Objective: This study investigated the association between use of sedatives in terminal cancer patients near death who were receiving home care and the home care period. Methods: We conducted a retrospective review of the medical records for 1032 cancer patients who received home palliative care from 17 specialized home care clinics between June and November 2013. We checked the use of sedatives within 48 hours before death at home, and we compared the home care period between patients with and without sedation. Results: The sedatives used were diazepam (n, %: 100, 52%), flunitrazepam (29, 15%), bromazepam (27, 14%), midazolam (26, 13%), and phenobarbital (20, 10%). The median home care period (median [quartiles]) was 26 [13, 63] days and 25 [10, 64] days (Adj p=0.79) for the patients with and without sedatives, respectively. Conclusion: Among terminal cancer patients near death receiving home care, 24% were administered sedatives, with more than half of those patients receiving diazepam. There was no association between use of sedatives and the home care period.
ABSTRACT
Purpose: This study was performed to compare the characteristics of home palliative care for elderly patients with cancer between age groups. Methods: The clinical records of 1,032 patients with cancer who received home medical care from June to November 2013 were reviewed retrospectively. Patients were classified as non-elderly (<65 years old), young-old (65-74 years), old-old (75-84 years), or oldest-old (≥85 years), and these groups were compared with respect to demographic characteristics, patient/family problems, outcomes, and medical care and services provided. Results: There was a higher percentage of patients with no caregiver in the oldest-old group than in the other groups (18%, p=0.014), while the young-old and oldest-old groups had a higher percentage of problems related to caregiving such as caregiver burden or absence of a caregiver (32% and 33%, p=0.002, respectively). In addition, the percentage of patients who required visiting nurses and care was higher in the old-old group (86% and 30%, respectively) and oldest-old group (89% and 35%, respectively) compared with the other two groups. Conclusion: Problems related to caregiving, such as caregiver burden or absence of a caregiver, were greater in the old-old and oldest-old groups, and a higher percentage of patients required visiting nurses and care in those two groups.