Objective: To examine how home-visit nursing contributed to the continuation of home-based care for a
patient undergoing peritoneal dialysis (PD) with declining cognitive and physical function.
Patient presentation / Case presentation: An elderly man in his 80s with progressive cognitive
impairment and decreased activities of daily living (ADLs) experienced significant challenges in both
self-care and family support. Despite these limitations, he continued PD at home until the end of life
with support from home-visit nursing services.
Nursing practice / Intervention: Home-visit nurses took full responsibility for PD-related procedures
while also providing daily assistance with meals and personal hygiene. Care was flexibly adapted to the
patient's changing condition, helping ensure safe and stable home treatment.
Discussion: The continuation of PD at home requires coordinated efforts across healthcare and
caregiving services. Under the current insurance system, home-visit nurses are often expected to provide
caregiving support in addition to medical care, particularly when formal caregiving services are limited.
Conclusion: This case demonstrates that comprehensive home-visit nursing, encompassing both clinical
procedures and daily life support, can enable patients with impaired self-care capacity to continue PD at
home until the end of life. Enhancing interprofessional collaboration and system-level coordination is
essential to support such home-based care.
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