ABSTRACT
Regional cooperation in palliative medicine involves multidisciplinary team care. It is very important for cancer patients to choose an appropriate place of stay during their end-of-life period. As the Nagoya Memorial Hospital does not have a palliative care ward, collaborating with other facilities offering palliative care and home care becomes pivotal. Therefore the Higashi-Nagoya home care social gathering was organized to improve communication and cooperation among regional health care professionals. Through discussions during this social gathering, the communication tools for cooperation in palliative care were outlined in November, 2015. We reviewed the outcome of 35 patients referred from our hospital using the communication tools for cooperation in palliative care: 25 patients were referred to chronic care hospitals including palliative care facilities, and 10 patients received palliative care at home; 23 died in the palliative care ward, 6 died at home, and 4 died at our hospital. A questionnaire survey conducted among the community health care professionals revealed that the introduction of this tool would be useful in providing accurate information on the prognosis of patients, level of understanding between the patients and their family, and patients’ views on life and death. Using the communication tool for communication would contribute to realizing seamless palliative care in the region surrounding our hospital, which would in turn lead to local team work and shared responsibilities to provide optimal palliative care.
ABSTRACT
Mohs' paste is a histopathological fixative with zinc chloride as the main ingredient. It has been applied to perform chemosurgery of skin tumors. In recent years, this paste has been reportedly very effective for control of various symptoms of skin metastasis in inoperable advanced cancer, such as pungent odor and hemorrhage in the field of palliative care. Shigeyama et al. modified the composition of the original Mohs' paste in order to regulate its viscosity; they added glycerin to a mixture of zinc chloride and zinc oxide. However, there may be difficulty in pasting this agent to a target region, because of its very high viscosity. Therefore, we devised two methods to overcome this difficulty; one was to paint the surface of a small piece of gauze with Mohs' paste, and the other was to apply the paste directly on the gauze and apply it to a lesion. We called the above two modifications, "Mohs' gauze method A and B." Mohs' gauze was used for the treatment of hemorrhage, pungent odor and huge exudate from a metastatic skin tumor of gastric cancer. These conditions disappeared without any side effects. We did not recognize the difference in fixation effect of the lesion between the conventional Mohs' paste method and our Mohs' gauze methods. Our method should make the Mohs' paste easier to apply, and might extend its indication. Palliat Care Res 2011; 6(1): 324-329