[A case report of a terminally ill patient who died of cancer at home under pain control].

Ninety percent of patients we handle at our visiting nurse group are last stage cancer patients. We report a terminally ill cancer patient who died at home under a high dose of powerful opioids to control pain. The patient was a 69-year-old woman with colorectal cancer. She lived together with her husband and their elder son's family. Even though the patient's condition dramatically shifted time to time, we could maintain a good QOL of the patient till her death at home. After the outpatient chemotherapy treatment began, we confirmed the patient's colorectal cancer had spread to her bones. We started using powerful opioids for pain control and the patient was eventually transferred to home hospice care. Then, the patient suffered a self destruction of the cutis metastasis layer and the disease caused broken bones on her left thigh. We however continued on providing home care service because of the patient's strong desire to stay home even if the family's concern as a care giver had multiplied. We increased the frequency of home visits and telephone calls in order to give medical and spiritual support for both the patient and her family. As a result, we could keep the patient's good QOL up to the time of her death. Based on the experiences through taking care of the patient, we strongly felt that the timing of proper guidance for the peaceful death to the family, a communication method or a communication system and telephone call visits were very important, in addition to controlling the condition of illness in order to keep up a good QOL for both the patient and her family.