[A case of a patient in welfare facilities in whom relief from sharp pain was difficult to achieve]

Because of the declining availability of hospital beds due to increasing demand, patients with terminal cancer are entering welfare facilities. A patient in whom relief from sharp pain was difficult to achieve in welfare facilities was referred to our clinic. He was an 87-year-old man who had undergone resection and colostomy for advanced rectal and bladder cancers. Although opioid was used to control carcinomatous sharp pain, the pain control was insufficient at the beginning of treatment. It is unusual for welfare patients to complain of pain, and few nurses in such facilities are experienced in the use of opioid. Information sharing was measured among the staff, and palliative care was found to be substantial. In addition to a family physician, a pharmacist's cooperation is effective for the education of staff in welfare facilities, and interregional association was useful in this regard. By assessing the patient's condition and performing palliative care, we were able to tend to the patient in the welfare facilities in the absence of a full-time physician.