Abstract
Consultation for terminal cancer patients is often only requested when psychological problems become severe after their general condition deteriorates. Therefore, how to perform effective consultation in the limited time available presents a problem. We experienced a case of collaboration with a terminal cancer patient, who was encouraged to record a voice letter for her family in the short time available before death. The patient was a 42-year-old housewife who was found to have breast cancer 5 years previously. She was informed of the diagnosis and an operation was performed. She was hospitalized with metastasis to the brain, and was referred to our department because of anxiety about the future and restlessness. Her general condition was poor and she had disturbance of consciousness, so treatment by structured psychological interviews was difficult. The patient was worried about matters such as bullying recently experienced by her child and the fact that she could do nothing about it. Therefore, it was suggested that she tape record a voice letter to her family whom she could no longer meet very often, and several taping sessions were held. As a result, relations between the patient, her family, and the health care staff changed for the better. The patient's feeling of despair("I can't do anything about it myself")was eased. Communication within the family improved, and communication between the health care staff and the patient was also promoted. In terminal cancer patients with a poor general condition, structured interviews are not an effective means of communication, but intervention by such methods as tape recording is possible. Taping was useful for this patient, but in patients with a slightly better general condition, support should be given so that they can create their own materials in any way that they wich if it is possible in the hospital setting. These materials are very valuable mementos for the survivors when there are small children or others whom the patient regrets leaving behind.
