| 英文摘要 |
As Taiwan is becoming an aged society, the number of its senior citizens with disability has been on a steady rise, rendering home care an increasingly crucial issue. Home visit doctors in Taiwan are mainly family physicians who are expected to provide accessible, continuous, comprehensive, and patient-centered assessment and care. This case report presents a 93-year-old bedridden woman, a home care recipient, with a history of stroke. She had chronic hyponatremia and was regularly followed at a nephrology clinic. The home care family physicians, after assessment, prescribed an increase of dietary salt and water restriction; her hyponatremia, however, showed neither improvement nor deterioration. The patient finally died of hepatocellular carcinoma. Post-mortem review of her medical records noted a positive anti-HCV test result at a previous health examination, yet no regular follow-up examination was provided. The differential diagnosis of hyponatremia in this patient, the common etiology of hyponatremia in the elderly, the association between hepatocellular carcinoma and hyponatremia, the protocols of follow-up for chronic viral hepatitis, and an analysis of medical ethics are discussed by literature review. The goal of this case report is to help family physicians provide appropriate holistic care for home health care patients. |
