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There are many elderly patients with poor oral intake when they are hospitalized with pneumonia or urinary tract infection, and we often need to consider their proper feeding method, such as percutaneous endoscopic gastrostomy(PEG)or total parenteral nutrition(TPN). However, it is difficult to receive homecare services for patients who rely highly upon medical treatment. Meanwhile, a prolonged hospitalization is a serious social problem. Here, we report two cases of elderly patients who were able to eat because home parenteral nutrition care and seamless approach were provided by multi-professional team.

Miyamori T.,Kawasaki Total Care Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2010

We defined and discussed care failure as a concept of failure in home care in this study.Care failure is defined as an explanatory model of the pathology of home care. In care failure, the patient and family confront on the subject of physical, psychological, socio-economic and spiritual problems simultaneously. Nursing care shortages caused by the care failure tend to get worsen if the vicious cycle is neglected. With minimal family-care capacity, home care easily results in care failure. We need, not only medical care but also an enhancement of nursing-care capacity for the treatment and prevention of care failure.

Ando T.,Kawasaki Total Care Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2010

In case of home care patient's health gets deteriorated, an admission is often requested due to a nursing care need rather than a medical need. However, it is often inevitable to transfer a patient to other nursing home, or to observe the patient at home, is caused by a limitation of medicalre sources and the capacity of the patient to adapt environmental changes. It may be criticized that a medical care of the elderly at home is left unattended as a consequence of the oversight of critical pathophysiologic changes. We have experienced a case diagnosed as Creutzfeldt-Jakob disease, which was not suspected at the initial visit of our ER unit. A grave hidden disease was recognized by next day's emergency visit and a follow-up elaboration examination at our hospital. Such cooperation may have a potency maintaining a home medical treatment level by grasping the precise pathophysiology of home elderly patients.

Sato K.,Kawasaki Total Care Center
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

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.

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