Dr Kashiwagi: "In Japan, sedation of the terminally ill is a big issue. About 60% of dying patients with extreme fatigue and severe dyspnoea ask to be put to sleep for the last few days of life. Intermittent sub-cutaneous infusion of midazolam is used."
Dr Co-Shi Chantal Chao: "In Taiwan, terminal agitation and the request for sedation is low (20%)."
Dr Catherine Krings: In Philippines, it is rare (1-2%)"
Dr Hinohara: "The environment for the patient makes a difference. We need to explore various therapeutic modalities to decrease this terminal agitation."
Dr Co-Shi Chantal Chao: "In Taiwan, a Buddhist hospice is using herbal remedies, acupuncture and chi gong."
Dr Nishitateno: "Is total symptom control possible?"
SECOND SESSION: SEEKING SOLUTIONS
Peace House Hospice, Saturday 22 February 1997 (Morning)
INTRODUCTION TO SESSION 2
After Dr Nishitateno welcomed participants to the Peace House Hospice, Dr Cynthia Goh outlined plans for the session. It was agreed that four main topics would be discussed: the definition of palliative care, palliative care education, allocation of resources and drug availability.
1 DEFINITION OF PALLIATIVE CARE
Dr Nishitateno: "All hospice patients in Japan are cancer patients because government hospice funding is for cancer or AIDS patients."
Dr Kashiwagi: " However, there has only been one AIDS death in Japanese hospices. In Japan, AIDS patients are treated in general hospitals."
Mrs Nelly Fung: "In Hong Kong, hospice was initially for cancer patients. But recently there has been interest in caring for AIDS patients and three hospices will now take AIDS patients. Hospice staff are being sent for training in the care of AIDS patients. An AIDS hospice will open in March 1997. However, it is not intended that hospice care of AIDS should develop as a separate stream."
Dr Sunaryadi Tejawinata: "In Indonesia there is a low incidence of HIV infection, Palliative care programs are only caring for cancer patients."
Dr Co-Shi Chantal Chao: "In Taiwan, hospices accept only cancer patients. At present the policy is that AIDS patients are cared for in the two university hospitals. However, after the year 2000 the hospices will take AIDS patients."
Dr Hong; "In Korea, the incidence of HIV infection is low. At present the hospices take only cancer patients."
Dr Devaraj: "In Malaysia, hospice is only home care of cancer patients."
