[How to support the death at home].

Forty-three patients who were taken care of at home were divided into three groups according to the place of their death to examine the cause of death at home and to improve the home care service, especially for supporting the death at home. Group A included 15 patients who died at home, group B included 22 patients who died at the hospital and group C included 6 patients who were transferred to our hospital by ambulance to confirm they were dead. In group A, 8 patients died from cancer, 5 from old age, 1 from chronic heart failure and 1 from Wernicke's encephalopathy. In group B, 8 patients died from pneumonia, 3 from other acute diseases, 4 from cancer, 4 from other chronic diseases. In group C, 5 patients died from old age and 1 from cancer. After the home care service was changed to 24-hour support, the number of patients who died at home increased from 1 to 14, and the emergency transfer by ambulance decreased from 5 to 1. The patients with chronic and gradually deteriorating conditions, such as cancer and aging itself, tend to die at home and this is effectively supported by the 24-hour home medical care service.