Palliative Care and Transfer of Home Medical Care in Terminal Stage Patient(Symposium,Palliative Care,The 72nd General Meeting of the Society of Tokyo Women\u27s Medical University)

Of all inpatients at Tokyo Women\u27s Medical University Hospital (TWMUH) in 2005, 25% had malignant neoplasms, and 70% of patients who died had malignant neoplasms. The mean length of admission was 35.6 days. We established a palliative care team consisting of multi-disciplinary voluntary members in 2005 and worked with home care support/promotion teams to provide high-level quality of life (QOL) care to patients and their families. Home care was requested by 400 patients, 66% of whom had malignant neoplasms. Home care transfer patients accounted for 64%, 21% died in TWMUH, and the remaining patients were transferred to another [OK?] hospital. After home care transfer, 23% died at home and 60% died after reentering the hospital. The mean term of home care was 49.0 ± 48.1 days and 45% of the patients died within one month of home care. The following factors need to be taken into consideration when transferring patients with terminal-stage malignancies to home care: 1) palliative care 2) desire to receive home care 3) understanding of the patient\u27s disease 4) nursing care system 5) local cooperation. Patients who are cared for in hospital until death also require adequate palliative care. The work of the palliative care team has to meet the high expectations of patients, their families and the medical staff. Efficient coordination of a large number of staff is essential to achieve high-level QOL care for terminalstage patients