Home Care FAQ

Question 3; What should I do before receiving home care?

You should choose your home doctor, prepare care insurance, solve concern about medical expense.

Social workers (MSW) of regional medical liaison office of hospitals will listen to your problem.

Contact social workers of the hospital you are visiting or staying in.
Preparing care insurance is also important.

You or your representative can go to care insurance section of municipal offices to ask about care insurance.

If you let us know who your hospital doctor or house call doctor is, the process will be smooth.

After applying for care insurance, you should choose your care manager.

Doctors are managers of treatment, and care managers are managers of care giving.

You should choose a care manager who can contact your doctor, work near your home, and has a good reputation.

Even if you are told to leave the hospital suddenly, you don’t need to worry.

You can find a care manager to arrange for a care bed quickly depending on the situation.

Although it usually takes a month for your care insurance to be approved, if it’s expected to be approved certainly you can start using the care bed before the approval. So, contact your care manager.

Nowadays people who support home care, such as care managers, social workers, visiting nurses and house call doctors often have a meeting in your hospital before you leave it. This is called a pre-discharge conference.

This is the first time all the members gather, so it’s a great chance for you to solve your concerns.

Question 5; I’m worried because my doctor told me I’m not in a condition to go home.

As cancer advances, you might have pain, or your respiration might become unstable.

Cancer also might cause ileus, and you may have a tube inserted through the nose into the intestine. In such cases they might assume you are not in a condition to leave the hospital.

In fact, nothing is impossible with home care.

If you want to stay at home with your family, let your doctor know.

You can also contact social workers of a regional medical liaison office, or a medical counseling room.

Ask them to introduce a house call doctor and a care manager, start preparing care insurance quickly, and let’s switch to home care.

Question 6; how do you relieve cancer pain?

Cancer pain can be relieved in many ways.

It can be relieved when you have a sense of security that medical staff can visit your home anytime, for example.

Sometimes normal headache medicine, instead of special medicine, can relieve your pain.

If it doesn’t work, we will use medical narcotics.

These narcotics are properly formulated for medical use, so you don’t need to worry about its safety.

It will never cause addiction or hallucination. It doesn’t disable you either.

For example, medical narcotics are administered to patients after surgeries in hospitals, which allows them to leave hospitals earlier than supposed to be.

Similarly, appropriate use of medical narcotics allows patients suffering cancer pain to live happy lives.

There are many ways to use medical narcotics at home, such as internal medicine, skin patches, suppositories, drips.

For strong pain, we have medical narcotics for emergency which you can use repeatedly, so please don’t worry.

Question 7; How do you know when the last moment comes?

When the patient’s time on earth coming to an end, the following changes occur;

1.The patient sleeps longer than before, and wakes up when spoken to,
2.The patient eats less, and loses weight.
3.The patient sometimes talks about the dreams he/she had.
4.The patient sometimes yells and looks angry.
5.The patient has incontinence.
6.The patient may cough intensely and produces sputum.

In such situations, the patient’s pain will gradually pass away.
As cancer further advances, the following changes occur;

1.The patient hardly moves even when he or she is spoken to.
2.The patient breathes deeply and stops breathing, then breathes deeply again.
3.The patient breathes moving his/her chin up and down. This is called mandibular respiration. Although the patient appears to be suffering, he/she doesn’t feel pain, so his/her family doesn’t need to worry about it.
4.Soon the patient will go into cardiopulmonary arrest.

Cardiac arrest can be confirmed by taking the patient’s pulse. If the patient’s family contact the doctor when the patient stops breathing, the doctor will visit the patient’s home to confirm cardiac arrest.
The patient passes away peacefully at home being watched by his/her family.

You don’t need to panic or call an ambulance. Confirm that the patient stopped breathing and is resting in peace, and contact your house call doctor.

The house call doctor will visit your home, confirm the patient’s death and issue a death certificate.
Then if you contact undertaker’s office, they will clean the patient’s body. Everything is done quietly.

Question 8; What should I do for the last moment?

In hospitals a doctor will be present at the last moment to confirm that the patient has passed away.

Whereas, in case of home care, the patient’s family should confirm arrest of breathing, and call the house call doctor.
The doctor will visit your home and issue a death certificate. Although the patient is not breathing, he/she is resting in peace, and there is no need to worry.

There is no problem for passing away at home, so please don’t worry about it.
You can contact house call doctors 24 hours a day, 365 days a year.

Although we would like to send the doctor immediately, sometimes it’s not possible due to emergent house calls for other patients.

Even if several hours pass after the death of the patients, there is no problem.

You can spend time with the patient until morning without any legal problem. So please don’t worry.

Question 9; What kind of procedure will be taken then?

If the patient passes away at home, the doctor who received contact will visit the patient’s home and issue a death certificate.

Then visiting nurses and undertakers will visit the patient’s home to clean the body.

Since the patient is resting in peace, so please don’t worry. Everything is done quietly.