End of Life Care at Home from Psycho-somatic Medicine(Psychosomatic Issues for Primary Care Physicians Facing in Super-aged Society)

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  • 在宅看取りにおける心身医学的ケア(超高齢社会におけるプライマリ-ケア医の心身医学的課題,2014年,第55回日本心身医学会総会ならびに学術講演会(千葉))
  • 在宅看取りにおける心身医学的ケア
  • ザイタク ミトリ ニ オケル シンシン イガクテキ ケア

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Abstract

In late years, the death tolls continue increasing with the progress of the aged society. It is predicted that approximately 1,700,000 people who are about 1.5 times as old as the present will die in 2038, and that the present medical system of Japan will not cope with the dead only at hospitals. It is also expected that at-home palliative care will increase in the future. The psychosomatic medicine-like approach is an important theme in the end period. Along with physical pain, social pain and mental pain, a spiritual pain appears in the end period. The correspondence to these pains is demanded of primary care physicians. Furthermore, a process to accept death is modified by these pains and may sometimes makes the physicians worry about how to support patients. However, the basis of care lies in encouraging patients and their families' decision making under any circumstance with appropriate communication techniques with each different situation. Needless to say, the decision making swings depending on the situation and needs various support. The sincere listening closely and the posture to snuggle up to patient and family running life, is extremely important. As a result of having repeated these backups many times, at-home death comes to realization.

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