[For terminal cancer patient inserted with four tubes to live at home--from discussion with family].

The patient was an 86-year-old man with mild dementia, and a urinary bladder catheter already inserted for benign prostata hypertrophy. At this time he had jaundice due to duodenal papillary cancer and was inserted with a percutaneous transhepatic bile drainage tube (PTBD). Additionally, due to an obstruction of his duodenum, he received a percutaneous endoscopic gastrostomy tube (PEG) for suction of gastric juice and intravenous hyperalimentation catheter (IVH) for nutrition. He always wished to return home. The medical staff and his family discussed this many times to realize his hope. We his daughter-in-law how to handle the 4 tubes. When she learned how, he went home and was on the visiting care system. But only one week after, despite his stability, his son, who was living apart got drunk and sent him back to the hospital. We tried to persuade them, including all family members living apart. At last he could return home again, and one week after died quietly at home. We learn from this case that it is important and very difficult for a family to accept a terminal cancer patient at home. It is necessary to advice them from two stand-points, the medical techniques and the mental aspects.