A Study of the Challenges of End-of-Life Care for Terminal Patients in Acute Care Hospital

DOI
  • Irizawa Hitomi
    Hyogo College of Medicine Institute for Advanced Medical Sciences Laboratory of Cell and Gene Therapy Juntendo University Graduate School of Medicine Department of Hospital Administration
  • Kobayashi Hiroyuki
    Juntendo University Graduate School of Medicine Department of Hospital Administration
  • Sakurai Junko
    Juntendo University Faculty of Health and Nursing
  • Karasawa Saori
    Juntendo University Graduate School of Medicine Department of Hospital Administration
  • Kawasaki Shiori
    Juntendo University Graduate School of Medicine Department of Hospital Administration

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Other Title
  • 急性期病院で看取られる終末期患者のエンドオブライフケアにおける課題の検討

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Abstract

<p>  In Japan, home death has decreased due to urbanization and nuclear familization, and since 1976, the rate of hospital death continues to exceed that of home death. As the rate of hospital death has now reached approximately 80%, improvement of the care of end-of-life patients is an issue even in acute care hospitals. In the nursing records of one acute care hospital, Juntendo University Hospital, the Japanese expression “Minookidokoroganai” is often used to refer to patient-specific-distress at the end of the term of life. In this paper, we report the electronic medical record of one patient who was nursed during the final moments of life at Juntendo University Hospital, and examine the circumstances of the assessment of “Minookidokoroganai”. As a result of the examination, when the nurses judged that the distress peculiar to the terminal-end patient was not sufficiently alleviating the symptoms in the ongoing treatment, the nurses used the Japanese expression “Minookidokoroganai” meaning that the medical team should quickly diagnose the cause of the pain and expand the range of treatments. In such a context, we consider the appropriate modality in the context of Ethics.</p>

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