Purpose: With a decreasing degree of independence in excretion movement, terminally-ill cancer patients experience an emotional distress and a lower sense of self-esteem. We herein report a case in which a patient received an effective excretion care by a palliative care team. Case: A female patient in her 60s was diagnosed with lung cancer and multiple bone metastases. On admission, she maintained her basic ADL (Activities of Daily Living) and walked independently; following a fall in the bathroom, however, she sustained a pathological fracture in the left humerus that was treated conservatively from a prognostic point of view. Despite concerns about pain and fracture risks during her trips to and from the bathroom, she wanted to excrete “on the toilet.” Out of respect for her wish and sense of pride, we gave her movement, lifting, and undergarment operation trainings in addition to adequate pain control. We also adjusted the equipment and increased the carers for her. With a gradual worsening of pain and a decline in ADL, she nevertheless had been able to perform excretion movement until the last moment when she was placed under sedation. Conclusion: This case suggests that an effective excretion care is possible by team approach respecting patients’ QOL and sense of dignity.

Purpose: The present study was conducted to elucidate the gap in awareness of experience of care management and the actual work of being responsible for this field by spotlighting on the attributes of of case managers and who are in charge of care management of terminal cancer patients at home.
Methods: Anonymous individual style questionnaire investigation was conducted against a target of 443 care managers.
Results: 70.3% had experience being in charge of terminal cancer patients and there was a significant difference in that this was found in those of more than 5 years of experience and among those of full timer status. As for experience in regard to those with or without experience being in charge by basic type of job, there was not much significant difference.
As for awareness regarding being in charge of terminal cancer patients, those who felt “I want to avoid it”, remained in 25% and found more in non-fulltimers (P<0.05). As for those who thought that “health care providers are more suited to be in charge”, this was found in 70% of health care providers and 40% in welfare related individuls (P<0.05) and a significant difference was noted. As for awareness of “should not depend on specific profession and should be done fairly among professions and which was found in 80% of those who have less than 5 years among care support specialist profession and hence compared to those with more than 5 years, it was many, and a significant gap was found. Regarding need of education and training about care management of terminal cancer patients, 95% agreed there is.
Conclusion: Approximately 70% of all had experience with terminal cancer patients and particularly, among those with over 5 years as care support specialist, it became clear that full timers were in charge. However, about awareness of being in charge of care management, it became clear that there was an positive attitude toward who takes in charge without being restricting to specific individuals and not selecting by number of years of experince as care managers nor by basic job types. Therefore, it can be concluded that opportunity for education and training about care management of terminal cancer patients and consolidating education environment for self training is important.