Abstract
The object of this study was to analyze the causes of discontinuation of home care in ALS (amyotrophic lateral sclerosis) patients during the period from the onset to the critical stage of respiratory disorders and further to discuss possible supports to be provided. Discontinuation of home care was defined as the transfer of the place of care from home to non-home environment due to circumstantial reasons of patients. 29 previously published case reports were reviewed and analyzed. Additionally, 4 patients were interviewed. Items for analyses were conditions of main caregiver, the causes of discontinuation of home care as well as the places of care after of discontintion of home care. The findings included: 1) Out of 33 patients, 31 patients were transferred to medical facilities, one patient, to a welfare facility, and one patient died during home care. 2) Reasons for discontinuation of 32 patients excepting one patient who died at home were categorized into three factors: aggravation of physical functions, lack of family care potentials, and insufficient community support systems. Those factors were doubled or tripled in cases.
