Investigation of the Cases of Deaths at Home after Discharge from Palliative Care Unit

2019 
: Recently, palliative care units are required to provide home-care support. In our palliative care unit, we support withh ospital discharge according to patient's wishes. In 2 years since April 2016, 104 of 536 hospitalized patients were discharged home (home discharge rate 19.4%). Among these patients, 30 died at home. Using the cases of the 30 patients, we investigated proper discharge and home-care support. As a background factor, the existence of"care by a woman"and"opioid unused" was likely to facilitate death at home. The patient was widely introduced to 18 clinics in the local area, not a specific medical institution. As reasons for home discharge,"Advanced understanding of medical condition" and"Recognition of the goodness of home"was cited. The median time from discharge to death at home is as short as 14 days, and so cooperation between the hospital and the home medical team is indispensable. To that end, the hospital guarantees emergency hospitalization, and the home medical team needs to accept discharge of the patient who is approaching death.
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