[Leadership in the promotion of inter-professional collaboration in terminal cancer care].

Home care requires indispensable inter-professional/inter-organizational collaboration. However, due to differences in specialization, the language used, and work structure, medical professionals may be confronted with a gap between the ideal and reality of collaboration. In the present case, a 50-year-old female with terminal cancer wished to receive home care and was consequently transferred to her home. The patient has been receiving a 24-h continuous drip infusion via a central venous route and using a patient-controlled analgesia pump for pain management. She has chronic respiratory failure in addition to cancer-related pain. Furthermore, she has been injecting herself with insulin 4 times per day because she has type 2 diabetes. The patient requires almost full assistance in daily life. This type of home care is equivalent to inpatient care that requires inter-professional and inter-organizational collaboration by 12 professionals. The leadership of a care manager with knowledge of a patient's life and family background is essential in such cases.

[Home care for terminal cancer patients from the family and caregiver perspective].

The progression of home care provision is associated with an increased burden on the family, as patients tend to progressively become more dependent on medicine. In the present case, a family supported a patient by performing medical activities such as taking blood sugar measurements, administering insulin injections, exchanging fluids, managing each tube, handling medical devices, conducting status observations, and attending to emergency calls. Thus, the family caregiver undertakes duties that were previously performed by a nurse and interacts with the various professionals who visit the patient's home daily. Therefore, the caregiver undergoes a considerable amount of stress. Family caregivers with no medical knowledge or nursing experience require plenty of support, in order to fulfill a patient's requirements. The first step is the establishment of trust between the medical professionals and the caregiver. In the present case, because the trust had been established, interprofessional collaboration ensured that the patient received support until the end. Thus, we reported on the perspectives of the family and caregiver on home care for terminal cancer patients.