Background: A questionnaire survey was conducted among the bereaved families of patients who received home blood transfusion therapy to evaluate the quality of palliative care. Methods: The questionnaire consisted of the Care Evaluation Scale 2 to assess the quality of palliative care, the Good Death Inventory to assess quality of life at the end of life, and overall satisfaction. Data from 44 bereaved families were analysed. Results: The total mean score of the Care Evaluation Scale 2 was 80.1±10.0 and the total mean score of the Good Death Inventory was 54.7±7.5. In terms of overall satisfaction, 97.7% of respondents were satisfied. Factors related to quality of care were disease, which was significantly higher for “solid disease patients” than for “hematological disease patients” (p=0.05). And the factor related to quality of life was “health of the bereaved family during treatment”, which was significantly higher for “good” than “poor” health of the bereaved family (p<0.03). Conclusion: The quality of palliative care, quality of life, and overall satisfaction were all highly evaluated. Further multicenter research should be conducted in the future.

The accuracy and problems with the use of non-contact infrared thermometers (NCIT) for body temperature measurement in a palliative care unit (PCU) were evaluated. The study was conducted in adult cancer patients admitted to the PCU. Twenty-four hours after admission, the body temperature was measured in the axilla using a digital thermometer and in the forehead, temporal region, and neck using NCIT. An axillary temperature of 37.0°C or above was defined as a fever. Sixty patients were enrolled, and the cutoff value for a fever and AUC by the measurements using NCIT were 36.80°C and 0.851 in forehead group, 36.75°C and 0.843 in temporal group, and 37.1°C and 0.809 in neck group. At each site of measurement, the difference from the axillary temperature was smaller, and the range of limits of agreement was narrower, in the no-fever group than in the fever group. The forehead is considered to be the most appropriate site for body temperature measurement using NCIT in PCU. However, it was found that the temperature measured with NCIT shows a large variance in persons with fever.

Purpose: This study aimed to identify the roles of nurses who co-visit with home care doctors in end-of-life care. Methods: A qualitative study was conducted using semi-structured interviews and descriptive thematic analysis. Participants included nurses who co-visit with home care doctors, home care physicians, visiting nurses, care managers, and visiting pharmacists. Families of patients who experienced home-based end-of-life care also participated in the study. Results: Nine roles were identified: (1) assisting with medical procedures, (2) collaborating with physicians, (3) facilitating understanding of physician explanations, (4) supporting decision-making, (5) providing care to patients and families, (6) creating a supportive environment in the medical care setting, (7) collecting information and assessing from a holistic perspective, (8) coordinating with multidisciplinary teams, and (9) educating on end-of-life and palliative care to medical teams. Discussion: Through interviews with various stakeholders, the roles of co-visiting nurses were clarified. Compared to visiting nurses, co-visiting nurses with home care doctors have unique roles that unfold simultaneously with physicians’ medical care while serving as coordinators in palliative home-based care.

Two patients receiving home palliative care, suffering from severe pain due to lower limb necrosis, were treated with ultrasound-guided popliteal sciatic nerve block, which resulted in immediate and remarkable analgesic effects. Although the use of peripheral nerve blocks in palliative care has traditionally been limited, these cases demonstrate that the procedure can be safely performed even in the home setting. This technique may provide early pain relief in situations where strong opioid analgesics are insufficient, serving as a valuable adjunct during the initiation of pharmacological pain management.

Introduction: This case involves a death notification submitted by the legal guardian of a patient’s mother, who had dementia, following the death of the patient from nasopharyngeal cancer. Case: The patient was a 61-year-old man diagnosed with nasopharyngeal cancer with central nervous system invasion. Prior to his illness, he had not held a steady job and relied heavily on personal support services in his daily life. Although he was alert upon admission, his condition deteriorated without initiating guardianship procedures for his mother, who was his only relative and had dementia. As the disease progressed, he developed higher brain dysfunction and decreased consciousness. In response, the family court appointed a legal guardian for his mother. At the time of the patient’s death, this guardian submitted the death notification on her behalf. Conclusion: This case highlights the growing importance of the adult guardianship system in light of the increasing number of elderly individuals living alone or with cognitive impairments such as dementia.

Aims: To explore the impact of COVID-19 on palliative care units in Japan. Methods: The Japan Hospice and Palliative Care Association conducted 2 questionnaire surveys in March and November 2021. Results: Most facilities restricted visitation in palliative care units. When asked if COVID-19 affected the quality of care in the palliative care units, 34% in the March survey and 23% in the November survey answered, “I think the quality of care has decreased significantly.” Discussion: Visitation restrictions were practiced in almost all facilities. Many staff members felt that the quality of care had declined due to visiting restrictions, which significantly hindered activities in palliative care units. Conclusion: This study showed that palliative care unit staff recognize that COVID-19 has reduced activities in palliative care units and significantly deteriorated the quality of care.