Survey of the Circumstances of Cancer Patients Treated at Home and the Presence of Doctors and Nurses at the Time of Death

In recent years, the system for providing home medical care and palliative care has been improved, and the number of cancer patients who are treated at home until the end is increasing. The aim of this study was to investigate the circumstances of cancer patients who died at home and the presence of doctors and nurses at the moment of death. We conducted a prospective survey of end-oflife cancer patients receiving home visits from home care and palliative care clinics in Japan from 1st July to 31st December 2017. During the study period, we analyzed the mortality status of 676 patients who died in their homes, serviced by 45 clinics. Of these patients, 91% were living with families, 49% died on holidays or at night, and the doctor and nurse was present at the time of death in only 5.6% and 9.9% of cases, respectively. Most of the patients who died at home lived with their families, with few doctors and nurses present at the time of their patients’ death.

Octreotide acetate use for patient with cancerous peritonitis and postoperative gastric cancer in home hospice care setting

The patient, a woman in her 60's with gastric cancer, was diagnosed post-operatively with Schnitzler metastasis, and an artificial anus constructed for her. After receiving chemotherapy, she was admitted to the hospital with both increased lower abdominal pain and nausea. The exacerbation of cancerous peritonitis was suspected and confirmed at the start of continuous subcutaneous administration of octreotide acetate. One week after octreotide administration, the anorexia STAS improved from a score of 4 to a score of 1. Based on the desires of the patient and her household, she transferred to home hospice care, where she maintained good Quality of Life (QOL), again by octreotide acetate administration. Although octreotide acetate is effective in treating nausea, the emesis accompanying cancerous peritonitis, or for the relief of abdominal distension symptoms, there are restrictions associated with inpatient care. In home hospice care, octreotide acetate administration is useful for the maintenance and improvement of a patient's QOL. Therefore, we suggest that octreotide acetate could serve as an important tool for home hospice care. Palliat Care Res 2009; 4(2): 321-329