Yamamura Momoka, Ikeguchi Ryo, Kosaka Makoto, Abe Toshiki, Zhao Tianchen, Yamamoto Chika, Endo Michioki, Sawano Toyoaki, Ishikawa Kazuko, Moriyama Nobuaki, Ozaki Akihiko, Tsubokura Masaharu, Beniya Hiroyuki
Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.
Orange Home-Care Clinic, Fukui, Japan.
Palliat Support Care. 2025 Jun 23;23:e125. doi: 10.1017/S1478951525100308.
To examine the challenges and practical realities of providing end-of-life care in welfare evacuation centers following the Noto Peninsula earthquake in Japan, and to identify lessons for improving disaster preparedness in similar settings.
Case 1: A man in his late 90s was transferred to a welfare evacuation center after contracting COVID-19 in a general shelter. He arrived with fever and marked physical decline. Acetaminophen was administered to relieve his fever and provide comfort. His condition gradually worsened, and eight days after arriving at the evacuation shelter, he died peacefully while being closely observed by medical staff. Case 2: A man in his 60s with a history of smoking and alcohol use was found bedridden and incontinent at home and was subsequently moved to a welfare evacuation center. Two days after evacuation, he complained of leg and back pain, which was suspected to be due to arterial occlusion. He was monitored and provided with supportive care at the center, however, pain control remained inadequate. Four days after evacuation, he was found in respiratory arrest and was confirmed dead.
These cases underscore the need for establishing unified guidelines and external support frameworks for end-of-life care in disaster settings. In a disaster-prone country like Japan, scenario-based training and the integration of trained volunteers are essential to ensuring dignified care for vulnerable evacuees.
探讨日本能登半岛地震后在福利避难所提供临终关怀的挑战和实际情况，并确定在类似情况下改善灾难准备工作的经验教训。
病例1：一名90多岁的男子在普通避难所感染新冠病毒后被转移到福利避难所。他抵达时发烧，身体明显衰弱。给予对乙酰氨基酚以缓解发烧并提供舒适感。他的病情逐渐恶化，在抵达避难所八天后，在医护人员的密切观察下平静离世。病例2：一名60多岁有吸烟和饮酒史的男子在家中卧床不起且大小便失禁，随后被转移到福利避难所。撤离两天后，他抱怨腿部和背部疼痛，怀疑是动脉阻塞所致。他在中心接受监测并得到支持性护理，然而，疼痛控制仍不充分。撤离四天后，他被发现呼吸骤停并被确认死亡。
这些病例凸显了在灾难环境中为临终关怀建立统一指南和外部支持框架的必要性。在像日本这样容易发生灾难的国家，基于情景的培训以及训练有素的志愿者的融入对于确保为弱势撤离者提供有尊严的护理至关重要。
