[Evaluation of family function in home care].

Quantitative and qualitative analyses of a caring family are needed to improve home care. We propose a three-dimensional quantitative evaluation of family functioning. The first dimension is food, clothing, and shelter; the second dimension is patient, medical, and caring conditions; and the third dimension is the caring family condition. We used the home care score and Family Adaptability and Cohesion Evaluation Scale at Kwansei Gakuin(FACESKG)IV for the quantitative evaluation of family functioning. Narrative medicine and ethnography are valuable for the qualitative evaluation of a caring family.

[Palliative care workshop primarily aimed for physicians and nurses in order to improve the care of the end-of- life homecare patient].

Since 2008, we held a palliative care workshop primarily aimed for physicians, who engaged in clinical practice for cancer treatment. In order to improve the end-of-life stage patient care at home, we made all sorts of efforts not only for physicians, but we also made a workshop available for healthcare professionals to participate. There were more than 60 people participated the workshop: our 20% of physicians and 24% of nurses, 13% of nearby hospital and clinic physicians, 12% of pharmacists and 17% of nurses. According to our questionnaire survey, more than 90% of the participants were satisfied with the workshop. Only 8% of the participants expressed that the workshop was rather difficult. From our analysis of the results, it was clear that we attained a high level of participants' satisfaction.

[Evaluation of the family-care capacity by a home care score and management of home care].

We report the home care score (HCS) system to evaluate the capacity of care-giving family for the purpose of smooth and stable introduction of home care. We defined the family of low caring capacity characterized by low HCS as a "marginal family (in home care)". The HCS of a "marginal family" is less than or equal to six and decline easily to less than three by the progression of the disease or the environmental change, which means "care failure", the pathological status of home care. In the cases of low HCS, we should bear in mind the existence of a "marginal family", and "care failure". The close follow-up as well as the support of the community is indispensable for home care.