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.