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In 1965 I became a member of the newly-established department of neurology in Brain Research Institute of Niigata University. One of the most important theme for clinical neurologist was to offer medical care after discharge from hospital for serious or intractable neurological disease patients who would soon become unable to come to outpatient clinic. In 1978 Shinrakuen hospital in Niigata City launched the Continuing Medical Care Section providing home visit by doctors and periodical home nursing for medically dependent homecare patients. The stuff of that section started home care program for TPPV patient suffering from ALS from 1987. In 1990, they promoted with the members of Japan ALS Association the establishment the public rental system of Niigata prefecture of ventilator and the accessory medical instruments. They also collaborated with the stuff of the city office to establish the liaison conference for care of the intractable disease patients in Niigata City, which resulted in improvement of education and produced many useful system. The author opened in 1997 an organized clinic of internal and neurological medicine and on the basis of long term care insurance program in 2000 put into practice the home care system of cooperation between municipal administration, medicine and nursing.

Construction of regional system in support of homecare -What's required for clinical neurologist from patients-