Among users of our visiting nurse station in 1997, 53 (58%) were cancer patients, and among these, 35 (66%) required pain control. Because home patients, family, and health care personnel are physically separated, nurses must provide reports and adjustments to physicians that assess pain holistically on the basis of estimated patient status and condition. Nurses also play a central role in providing necessary information to the patient and family, providing drug administration guidance and other response when pain occurs, and performing reassessment. To provide an understanding of the role nurses play in pain control in the home, the current research describes how nurses assess and respond to pain among cancer patients requiring pain control by analyzing the nursing records of 9 terminal cancer patients residing at home for a period of 1 month or more. The results indicate that nurses form pain estimates by observing pain-related indicators during visits and by assessing such factors as the cause of pain, the effect of analgesics, and effects on daily life. Based on these estimates, nurses provide care independently, make adjustments with physicians, and devise plans to counter subsequent pain. These facts suggest that estimations based on appropriate nurse assessments are crucial in "at home" conditions.