In recent years, cancer treatment methods have diversified, and there are increasing numbers of occasions where patients or their families are required to make increasingly complex decisions. Currently, there are no guidelines for determining the process and the individual who decides the treatment strategy for cancer patients who are unable to decide for themselves. Particularly, no report has been published on decision-making for end-of-life care in patients with intellectual disabilities. This report documents our involvement in decision-making during end-of-life care for a cancer patient with intellectual disabilities. This patient’s decision-making ability or lack thereof was determined using reliable and validated assessment scales. The collective decision to not resuscitate in case of cardiac arrest and to care for the patient in the palliative care unit was made through a multidisciplinary collaboration between the social welfare team and the hospital based on reports and guidelines from abroad. Going forward, guidelines for decision-making support for terminal ill cancer patients with intellectual disabilities and decision-making by proxies for such patients need to be established in Japan.

Purpose: To evaluate the usefulness of asenapine sublingual tablets for the treatment of delirium in patients with advanced cancer. Methods: We conducted a retrospective study using electronic medical records of patients with advanced cancer who were admitted to our hospital between October 1, 2019 and September 30, 2022 and who received asenapine sublingual tablets as treatment for delirium. The Agitation Distress Scale (ADS) was used to evaluate the degree of improvement of agitation symptoms caused by delirium. Results: Twenty patients were included in the analysis. The mean ADS(range) before treatment was 12 (4–17), and the mean ADS(range) after treatment was 7.9 (0–18), with the p-value <0.001. Conclusion: Asenapine sublingual tablets may be useful as an option for pharmacological treatment of delirium.

Purpose: This study aimed to report on the multidisciplinary web conferences for patients with heart failure to strengthen medical collaboration and provide seamless support. Method: We described and analyzed the web conferences by retrospectively collecting data on the conferences. Result: Main subjects of the conferences were those who lived alone and had inadequate nursing care, and those to whom the intervention of multidisciplinary professionals needed to be strengthened to prevent readmission. Using web conferencing tools, we shared issues and solutions for discharge with considering the anonymity of the patient’s personal information. The conferences were held once weekly for 30 minutes when the patients were in the stages of preliminary discharge planning. Participating physicians and healthcare professionals included cardiologists, nurses, pharmacists, physical therapists, nutritionists, palliative care physicians, and home doctors. The cardiology staff used a multifaceted checklist to clarify issues while sharing the patient’s condition and treatment plan. The palliative care physicians made suggestions about value-based treatment plans and decision support, and the home doctor made suggestions about home services, drug adjustment, and lifestyle guidance necessary to prevent readmission. Discussion: Further improvement in the web conferences and evaluation on the effect of the conferences are needed.