Abstract
Objective : This study was performed to increase understanding regarding the growth of home hospice care within home care agencies in Japan, and to discuss the role and definition of the home care agency as part of the medical care to improve home hospice care with particular attention to terminally ill cancer patients.
Material and methods : We sent a questionnaire to the presidents of 1485 home care agencies throughout Japan, and interviewed 5 medical doctors.
Results : A total of 73.4% of home care agencies provide home hospice care, and treat an average of 13.7 patients each year. Patients who died in the home per year averaged 3.2. The home care agencies with nurses experienced in home hospice care exhibited high performance ratios. Furthermore, home care agencies which do not provide home hospice care, are highly interested in the home hospice care program.
There are some differences between the home hospice care which home care agencies perform, and that provided by doctors. The necessity of a 24-hour response system has been suggested.
To improve home hospice care, close cooperation between doctors (who practice home hospice care, and those in hospitals) is important. Therefore, government and hospital support are necessary to develop programs and to provide factual education regarding home hospice care for doctors and nurses.
In addition, for the general public to accept home hospice care, extensive publicity and health education is essential.
Conclusion : This study suggests that home care agencies can play a key role in the home hospice care system, if these agencies provide a 24-hour answering and response system for terminal cancer patients, and if doctors are involved with the care program. Home hospice care in the Japanese medical care will greatly improve if government support is received to increase understanding, and to provide education for doctors, nurses and the general public.
