title: [Present situation of terminal care and home rehabilitation at Karuizawa Hospital].
abstract: Rehabilitation is usually considered to have the connotation of regaining function or reintegration into society, and no direction or achievement regarding the time of involvement or details of request has been suggested for the terminal rehabilitation in the patients with cancer who can't expect to have any improvement. Dieatz defines four phases for the goal of rehabilitation in the patients with cancer; Preventive Phase, Recovering Phase, Supportive Phase and Alleviative Phase. This time, we encountered a couple of cases in patients with cancer: patients who gained QOL through developing environment and setting goals that enable them to maintain the active daily life (ADL) at the supportive phase; and patients who realized us when relieving the pain while losing self-consciousness due to psychosomatic changes at the alleviative phase. In this report, we discuss what care can be provided at the phase when trust of the patient/family members is established, at the phase when care providers can grasp needs, and at the phase when the needs can be satisfied. We also report on how the patient and family member reacted to the direct hand massage provided by the physical therapist at the terminal stage. The rehabilitation system for home care at each phase is discussed in association with practical side and problems of the rehabilitation in the future terminal care.
authors.affiliation: Karuizawa Municipal Hospital.
authors.forename: Emi
authors.initials: E
authors.lastname: Komiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Sakura
authors.initials: S
authors.lastname: Sakakiyama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Miyao
authors.forename: Misa
authors.initials: M
authors.lastname: Yoda
mesh_terms: D000203:Activities of Daily Living; D003110:Colonic Neoplasms / Q000534:rehabilitation*; D003152:Community Health Nursing; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D011788:Quality of Life; D013727:Terminal Care