Home nursing care for terminal patients: An analysis of home nursing using visit records

Abstract

Background and Aim : The objectives of this study are to describe home nursing care for teminal cancer patients and identify the conditions that enable home terminal care. Materials and Methods : Home nursing records, patient records at outpatient clinics and inpatient charts were analyzed and visiting nurses were interviewed. The data thus obtained was then compared with literature references. Results : In two out of five cases, the patients personally decided to receive home terminal care. In the other three cases, the decision was made by the patient's family. The longest period of terminal illness spent at home was 7 months, while the shortest was two months. Home nursing was provided for periods of between nine days and 5.5 months. Two patients died at home and three patients died in the hospital. Hospital deaths were selected by two patients because of unendurable pain and by the family in one case where the patient could no longer receive adequate care at home. Visiting nursing services include medical care, hygiene care, advice on care by caregivers, health management of the family and service coordination. Visiting nurses prepared for the death of the patient in accordance with the wishes of the patients and their families. The patients and families depended on the visiting nurses, and the visiting nurses gave the patients and their families a sense of security because of their connection with the hospital. Conclusions : The following conditions are recommmended for home terminal care. 1 . The patient should have good pain control, and have hope in life while accepting death. 2 . A caregiver who is close to the patient, should be present. 3 . Family members must be able to accept the patient's death and their willingness to give care must be supported by other people. 4 . Family members must be willing to learn how to care for the terminal patient, and the visiting nurses must be capable of teaching care skills. 5 . A collaborative relationship between the hospital and other community resources, must be exists. (Kitakanto Med J 2001 ; 51 : 301-305).