[Roles and problems of nurses taking care of terminally-ill patients at home]

Since May in 1994, we have started to take care of terminally-ill patients at home to support patients who want to die at home and their family. Many patients in the terminal stage become stable temporarily from being back home, and their family are happy to care for them. Their family tend to think that they may well escape death, so they are sometimes confused when patients become worse suddenly. The author learned something important from the visiting care system in connection with two cases. Although case 1 had a short period of time at home and case 2 died in the hospital, their families were satisfied with our system and could accept patient's death without a big problem. It was very important to educate the family about death because it is very difficult to foresee a sudden change in terminal cancer patients. From the nursing standpoint, it remains to consider how to judge the patient's conduct and when to call the doctor. Another problem is whether to inform patients of their cancer or not.