Discussion
This case illustrates that home care can be a viable option in
end-of-life care for cancer patients, particularly during crises such as
the recent COVID-19 pandemic. Globally, a standard set of end-of-life
care is a hospice or palliative care ward which aimed to provide
holistic care to patients. While focusing on personalized care of
patients, hospice also seeks to ameliorate the tolls and hardship faced
by the family caregivers while taking care of their patients (3). In
contrast, this case demonstrated that home care would allow terminally
ill patients to stay where they feel most comfortable so that they could
cherish their lifetime memories and spend quality time with their loved
ones.
We believe that there are several other reasons to choose for home care
for end-of-life care during a COVID-19 pandemic. First, this would
alleviate communication problems between health care professionals and
family members. Restriction imposed due to COVID-19 has been reported to
reduce the quality of communication between hospitalized patients and
their family members, resulting in severe distress that may affect the
quality of death and bereavement (4, 5). Second, home care would
potentially ease the burden relating to COVID-19 care among medical
professionals in hospitals. End-of-life patients are considered a
vulnerable population and infection with SARS-CoV2 can result in the
development of serious illness. In addition to the risk of nosocomial
infection, work overload of these staff and logistic shortage are also
an issue. Given these reasons, home care could be considered as a viable
option at least for a while until the pandemic subsides.
However, home care also has its drawbacks. Health workers are not easily
available and it is more difficult to address patient’s health problems
in a timely manner compared to hospitalization. Further, there might be
a risk of COVID-19 infection due to frequent visits from health workers,
families, and relatives. In any case, patients must be informed about
the advantages and disadvantages of both hospice and home care so that
they can make their own choices autonomously.