Objective：The aim of the present study was to clarify issues for community care collaboration based on a death conference between hospital staff and community care practitioners who reviewed their support in the process from disease onset to death for a patient with amyotrophic lateral sclerosis.Methods：Data were collected from the conference materials and written conference records of the participantsʼ opinions. The researchers discussed and summarized the data to extract community care collaboration issues. The case in question involved a woman in her 60s who died following emergency hospitalization after 7 years and 6 months of medical treatment during which she had been hospitalized five times. She had received care from multiple community support staff, including nurses from two visiting nurse stations and doctors from three medical clinics. Results and Discussion：The number of changes of treatment location, the increased caregiver burden due to symptom deterioration, and the end-of-life stage represented crisis situations in the present case. After these situations were considered, the following issues requiring community care collaboration were emphasized： reduction of the family caregiver burdenʼ,family guidance and careʼ,collaboration between the hospital and the community attending physicianʼ andimprovements of the terminal care systemʼ.

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