The patient was a 61-year-old man. He was diagnosed as having dermatomyositis-pulmonary fibrosis in February 2005. Immediately home oxygen therapy (HOT9L/min.) and home visiting care were commenced. Since the patient had difficulty in breathing due to chronic respiratory failure, cyclophosphamide, an immunosuppressant drug, was given to him intravenously when a physician made house calls. The results were satisfactory.The Community Care Department of our hospital has a staff of physicians who exclusively provide home medical services and keep track of patients' health state systemically. Nurses in the Home Visit Care Station and the Home Care Support Center provide health services in patients' homes including nursing care and care of caretakers.The physician who visited the patient's home in this case belonged to the Department of Internal Medicine as a specialist of collagen diseases teamed up with the community care department staff to give home medical treatment using the immunosuppressant drips. This was a good example of the successful home medical treatment and care for a patient who was unable to go to hospital because of chronic respiratory failure.
Chronic ; Respiratory Insufficiency ; Patients ; Pulmonary Fibrosis ; House Call

We established the Technical Aids Support Office in our hospital to promote the introduction of and technical advice about assistive technology so as to enhance the quality of care and the functioning of patients and ensure staff safety. In this paper, we introduce two complicated cases that needed individual support. Case 1: A patient with amyotrophic lateral sclerosis. The amount of assistance required had gradually increased, but the patient still hoped to use a portable toilet. Because he could barely stand up, the height of the toilet needed adjustment. An elevated seat decreased the amount of assistance required. However, raising the bottom of the portable toilet turned out to be a challenge. Case 2: Multiple limb amputee. The patient and the caregiver experienced pain and distress during transfer between bed and chair. We tried using a lift assist device, but it the hardness of the sling worsened pain at the stump. A cushion with a sliding seat was then placed between the sling and the patient to reduce friction. The shape and hardness of cushion is a future challenge to solve. Timely individual support at each stage in their care for individual patients is indispensable for the provision of technical aid support.