A Father’s HPN Journey: The Final Companionship at Home

I have been providing Home TPN (Total Parenteral Nutrition) services for seven years now. Over these years, I have cared for a wide spectrum of patients—from teenagers to nonagenarians. Some gradually recovered with treatment, while others reached the final stage of life. Every patient has their own story, and a father with bowel cancer in Sha Tau Kok remains one of the cases I remember most vividly.

The First Time We Met, He Wasn't Talking About Treatment

The patient was a middle-aged man who, due to severe intestinal obstruction caused by bowel cancer, was completely unable to eat and required Home TPN treatment at home.  

During our first meeting, however, what he talked about was not the treatment itself. Instead, he expressed a simple wish—to stay at home and spend more time with his family.

There were two very young children in the living room. He understood perfectly well that his time was limited and told me that he no longer wished to shuttle back and forth to the hospital or spend the rest of his days in a ward surrounded by machines. His only wish was to stay home and spend more time with his family.

For many people, home is simply a place to live. But for patients approaching the end of life, home is often where they most want to be. Being able to see their family every day, hear their children's voices, and spend their remaining time in familiar surroundings can become their greatest comfort.

Doing Our Utmost to Minimize the Risks  

On the first day of assessment, the moment I arrived at the patient's home and pushed open the door, I immediately began conducting a clinical risk assessment.

On the first day of assessment, the moment I arrived at the patient's home and pushed open the door, I immediately began conducting a clinical risk assessment.

Home TPN involves a central venous catheter that leads directly to major blood vessels, and every step of the procedure requires strict sterile techniques. The home environment and care conditions presented certain challenges, meaning that infection control would require extra attention and meticulous preparation.The home environment and care conditions presented certain challenges, meaning that infection control would require extra attention and meticulous preparation.

Yet knowing that his greatest wish was to remain at home, we began asking ourselves: how could we help him fulfil this wish while maintaining safety and professional standards?  

We could not change the hygiene of his entire house, but we could strictly control the immediate procedure area. Before every TPN connection and disinfection, I spent extra time thoroughly cleaning the work surface with disinfectant, enhanced my personal protection, and completed the procedure using the most meticulous and precise sterile techniques to minimize the catheter's exposure time to the air. Meanwhile, I carefully briefed the family on the care details they needed to follow.

The service ultimately lasted for one week.

Although we took full precautions during the procedures, after several days of on-site observation and continuous assessment, we felt that if long-term continuation of this high-risk therapy became necessary, receiving care in a more controlled environment would likely be a safer option for the patient. Just as we were preparing to discuss the next steps with the family, the patient was admitted to hospital due to gastrointestinal bleeding and passed away shortly afterwards.

The True Meaning of Homecare  

People often ask what the value of homecare truly is.

When we provide homecare services, our primary goal is usually to buy more time for patients to be with their families, sparing them the grueling back-and-forth to the hospital and lowering the risk of cross-infection within wards.

Homecare is not merely about bringing medical services from the hospital into the home. It is also about finding a balance between professional clinical judgment and a patient's personal wishes.

We cannot change the outcome of every illness, nor can we extend every patient's life. But if, in the final days of life, we can help a father remain at home, spend a few more days with his children, and experience a little more warmth from his family, then that companionship itself carries profound meaning.

Looking back on this father with bowel cancer in Sha Tau Kok, I still remember his simple yet deeply moving wish—to stay at home. 

That one week of Home TPN care reminded me once again that medicine may not always change the destination, but it can sometimes allow patients to walk their final journey in the way they hope for most, surrounded by the people they love. Perhaps this is the true value of homecare—to seek a balance between clinical protocols and the realities of life, striving to create the most humane and compassionate path possible for our patients.

Read More:

From Hospital Ward to Home Care: My First Palliative Care Case at YDCare

Home Parenteral Nutrition (HPN) Support During Cancer Treatment

End-Stage Cancer Care: Passing Peacefully at Home