[Medical support system to enable advanced cancer patients to die at home]

Among 207 advanced cancer patients that received home care during the period from April, 1987 to December, 1998, 144 died in their own house, and 129 people were confirmed dead by a doctor of this department. Eighty (62%) of these 129 people died outside the hospital working hours. Moreover, 47 people (36%) died on a day the hospital was closed. The time difference between the actual death time and the doctor's death confirmation time was less than 60 minutes for 88 people, over 60 minutes for 41 people, over 120 minutes for 17 people, and over 180 minutes for seven people. The doctor in charge performed the death confirmation for 107 people (83%). Forty-seven people had received a visit by the doctor or nurse on the day of death, and 57 people had received a visit on the day before death. The existence of the medical support system of 24 hour correspondence and various guidance for the family on the method of making urgent reports when near death, how to spend the last hours, and the postmortem procedures were especially important in making home death possible.