title: [End-of-Life Home Care for a Young Patient].
abstract: We report the case of a young patient(under 40 years)with a malignant tumor; this is an age when a person is involved in social activity and is productive. A variety of activity largely has a negative influence on family at death of such a patient. After fighting this illness for a long time, home medical care was administered, and I experienced a case of a 31-year-old patient with malignant melanoma who was administered end-of-life home care. He had a diagnosis of right leg malignant melanoma approximately 5 years ago. Palliative medical care was decided, after aggressive treatment for approximately 5 years, including an operation, and home medical care was hoped, after this was introduced at our department of surgery. I performed pain control in this patient after hospitalization at approximately one week and the patient was shifted to home medical care. The patient could only swallow water, and oral medication could not be ingested because the patient was bedridden. The mother who was the main caregiver quit her work and devoted herself for care. I performed pain control mainly by administering oxycodone and a steroid and an anti-inflammatory, which were given intravenously along with the antianxiety drug. During home medical care, I focused on pain control, but the patient expressed gratitude for the main caregiver that was witnessed by the family. The patient died 26 days after the initiation of at-home care. Nursing care insurance is not available for young patients, and home help is limited. I quit work for the caregiver, and including contrivance of the future life, there is much limitation with the aspect of the income. A younger patient experiences temper, as well as physical pain, enough for mental and social pain is necessary.
authors.affiliation: Dept. of Surgery, Kureha General Hospital.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Midorikawa
authors.forename: Seiko
authors.initials: S
authors.lastname: Suzushino
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Tamotsu
authors.forename: Kinuyo
authors.initials: K
authors.lastname: Tomizawa
authors.forename: Nobue
authors.initials: N
authors.lastname: Hongou
authors.forename: Hiromi
authors.initials: H
authors.lastname: Usami
authors.forename: Mie
authors.initials: M
authors.lastname: Oyake
authors.forename: Haruna
authors.initials: H
authors.lastname: Murakami
authors.forename: Noriko
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D006699:Home Care Services; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000209:etiology; D010166:Palliative Care; D013727:Terminal Care
chemical_list: D000701:Analgesics, Opioid