The number of home care patients with intractable neurological diseases has been increasing. However, a doctor who specializes in neurology is not always involved in the continuing (follow-up) home care. From the perspective of a doctor who is a visiting physician, but is not specialized in neurology, this study considers the issues related to an introduction and cooperative efforts in home care with the aim of smoothly implementing the continuing (follow-up) medical care. Based on case experiences, it is believed that communication is important for building of the relationship of trust with patients, caregivers, and family members as well as a smooth cooperation with staff members in the team who are involved in continuation of medical care. Furthermore, it is thought that communication and cooperation through the exchange and sharing of information among doctors, who are specialists in neurology and visiting physicians, would result in both safer and more relieved feelings for patients, and are necessary for maintaining a better medical environment for home care patients. Based on the above, it is believed that communication is the key to the success of both smooth cooperative relationships among staff members in the team and a continuation of successful medical care for home care patients with intractable neurological diseases.