now difficult to care the old patient in their house, because there are few who can care the old patient. Recently the system of visiting doctor and visiting nurse has progressed sufficiently, but the user is few for the reason of above. I have a 84 year old female patient who suffered by Alzheimer disease and chronic nephritis etc. She has not appetite and can't eat herself. I advised her family to make an artificial nutrition fistula, but they refused to make it and even also nasal tube nutrition. She will go home tomorrow in short time. I told her family about the visiting doctor and visiting nurse. Her daughter in law has no business and live in her house. I must go to Tokyo tomorrow. I am going to ask to her family how to manage