私の家族は、この１～２ヶ月間、末期癌の祖父のことでバタバタとしていました。その話を少ししようと思います。
祖父はこの２ヶ月で２回も転院をし、３回目の転院を強いられています。
私は「もうすぐ病院から出されちゃうから次の居場所を探さないといけないんです。」と言う家族によく出会います。それに対して病院のスタッフが「別に追い出しているわけではないのに、みんなそう言うよね。」と話しているのをよく耳にします。
実際に自分が“患者さんの家族”になってみると、やはり「出される」という風に感じてしまいます。「せっかく本人も家族も落ち着いて慣れてきたのに、どうしてここに居させてくれないの？」と感じてしまいます。今の日本の医療の制度では、患者さんの状態によって入院先が異なるため、病院を転々としなくてはいけない場合があります。
祖父の場合は、下記の通りです。
急性期病院 …口腔癌の手術目的で入院し、手術は成功するが肺に転移する。
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癌の緩和ケア病院 …肺の癌の進行が早く末期状態のため転院したが、進行が止まり全身状態が安定する。
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療養病院 …寝たきりでは動けなくなるのでリハビリ目的で転院したが、肺炎になる。
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癌の一般病院 …肺炎の集中治療の為一時転院したが、なかなか回復しない。一時的に診てくれたが、癌専門の病院のため、転院を強いられる。（祖父は癌ではなく肺炎で全身状態がよくない為。）
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急性期病院、または、療養病院に転院予定。
それぞれの病院で、入院を待機している人がいるので仕方ないと思う反面、居たいところに居させてほしいと思います。
それぞれの病院でそれぞれのルールがあります。そのため“前の病院では一人でトイレに行っていたのに、次の病院では一人で行くと怒られる”“前の病院では痰を１時間に１回吸引してくれていたのに、次の病院では、全然、吸引してくれない”などのたくさんの変化があります。その変化は、本人はもちろん家族にとってもとてもストレスです。
病院の機能分化も必要だとは思います。しかし、それにより患者さんが転々としなくてはいけないとなると、日本の医療制度の見直しが必要だと感じました。
Recent events
My family has been very busy over the past two months or so because of my grandfather’s terminal cancer. Let me tell you about this a little.
My grandfather has changed hospitals twice over the past two months, and now he’s being made to transfer for a third time.
I’ve met a lot of families who worry about their sick relative being kicked out of their current hospital. They spend a lot of time searching for other potential medical facilities. In response to such worries, I often hear fellow hospital staff saying things like “It’s not like we’re going to kick them out, but everyone seems to think that we will, don’t they”.
Upon personally becoming a patient’s family member, I of course ended up feeling that same sense of anxiety about my grandfather being kicked out. I couldn’t help thinking “we’ve all calmed down and gotten used to this place, so why can’t you let us stay here?”
Under Japan’s current health care system, a patient’s hospital is determined by the type of condition they have. They often end up getting transferred multiple times. For my grandfather, it went like this:
At first he was taken in by an urgent care facility, where they operated on his oral cancer. The operation was a success, but then the cancer showed up in his lungs.
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The lung cancer quickly progressed to a terminal state, so he was transferred to a palliative treatment cancer facility. However, the cancer’s progression halted and his condition stabilized.
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Because he was bedridden and could no longer move properly, he was transferred to a rehabilitation hospital, but then he got pneumonia.
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He was then transferred to a general cancer hospital where they also administered temporary treatment for the pneumonia. However, the pneumonia did not get better, and became the primary cause of his body’s poor condition. Because this hospital specializes in cancer treatment not pneumonia, he is being made to transfer once again.
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The current plan is for him to move to another urgent care facility or another rehabilitation hospital.
On the one hand, the long list of patients awaiting transfer into specialized hospitals is unfortunate. Nevertheless, I think hospitals should let their current patients stay if they want to. Each hospital has its own set of rules, and a transfer can bring many changes in routine. At one hospital, patients might go to the bathroom by themselves, but at another the staff might get mad if they did that. At one hospital the staff might come and suction out mucus every hour, but at another they might not do it at at all. The list goes on. These changes can result in a lot of stress on the family, and of course on the patients themselves.
I do believe that health care specialization is necessary. However, the resulting patient transfer problem is surely something that needs to be fixed about the Japanese health care system.
– Aya Miyata
– English by Chay Schiller
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