Facilitators and barriers to continuing end-of-life care at patients' home : a qualitative study on care managers' perspective

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  • Abe Koshu
    Musashinodai family clinic Shizuoka Family Medicine Program, Hamamatsu University School of Medicine Morimachi Family Medicine Clinic
  • Abe Michiko
    Department of Family and Community Medicine, Hamamatsu University School of Medicine
  • Kaneko Makoto
    Shizuoka Family Medicine Program, Hamamatsu University School of Medicine Department of Family and Community Medicine, Hamamatsu University School of Medicine Department of Health Data Science, Yokohama City University
  • Fetters Michael D.
    Department of Family Medicine, University of Michigan
  • Narumoto Keiichiro
    Shizuoka Family Medicine Program, Hamamatsu University School of Medicine Department of Family and Community Medicine, Hamamatsu University School of Medicine
  • Inoue Machiko
    Shizuoka Family Medicine Program, Hamamatsu University School of Medicine Department of Family and Community Medicine, Hamamatsu University School of Medicine

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  • 在宅看取りを促進する要因と阻害する要因の検討：ケアマネジャーの視点からの質的研究

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Abstract

<p>Introduction : This study explores the facilitators and barriers to continuing end-of-life care at patients' homes，including noncancer patients' homes, through care managers' experiences.</p><p>Methods : We conducted semi-structured interviews with eight care managers providing end-of-life care at patients' homes in a rural area in the Shizuoka prefecture.</p><p>Results : The themes identified were “patients’wishes, ” “familes' will and situations,” “relationships surrounding the caregiver，” “awareness of patient's conditions and life expectancies，” “collaboration with medical and nursing professionals,” and “financial circumstances.” Facilitating factors for end-of-life care at patients' homes were family cooperation, and barriers were a lack of information about home care at hospital discharge and caregiver's burden when patients' life expectancies were difficult to predict.</p><p>Conclusion : Home medical and nursing care providers need to improve collaboration with medical professionals in hospitals when supporting patients' discharge. They also need to communicate appropriately with caregivers about each patient's life expectancy.</p>

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