This poem examines caregiving at the intersection of chronic illness, intimacy, and end-of-life uncertainty. Rather than presenting diabetes solely as a medical condition, it traces how care gradually becomes organized through numbers, routines, restrictions, and vigilance. Glucose readings, insulin doses, meals, wounds, and laboratory results function as recurring symbols of a relationship increasingly translated into clinical measurements. Against this numerical order, the poem foregrounds forms of care that remain unrecorded: sleeplessness, fear, touch, memory, and the quiet labor of staying present. The final movement shifts from disease management toward palliative recognition, where comfort and relational dignity become more important than strict control. By contrasting measurable indicators with immeasurable devotion, the poem reflects on caregiver burden, anticipatory grief, and the emotional transformation of a partner into an informal clinical companion. It ultimately asks how love may be reclaimed when treatment can no longer promise recovery.
Some people diagnosed with dementia don't want to live through dementia's advanced stages. This article presents a new practice, Minimal Comfort Feeding, and contrasts it with Medical Aid in Dying (MAID), Voluntarily Stopping Eating and Drinking (VSED), VSED-AD (by advance directive), and Comfort Feeding Only (CFO). Also presented are results from a survey of primarily palliative social workers about their opinions regarding MCF. These social workers report potential benefits and challenges with MCF. Practice implications include the need for organizational protocols, staff education and training, as well as appropriate support for all caregivers involved.
Drawing on personal bereavement, this poem reflects on the loss of a father's voice and the changing meaning of ordinary family communication after death. A brief voice message about buying rice, once heard as a simple everyday reminder, becomes significant only after the recording itself is lost. The poem explores the difference between remembering what someone said and remembering how they said it-the pauses, breath, tone, and familiar sounds that once seemed unremarkable. Through the disappearance of a digital voice message, the poem considers grief, memory, family communication, and the fragile nature of digital traces. It reflects on how ordinary words, often overlooked while someone is alive, may become deeply valued after loss.
Chronic liver disease, currently the 9th leading cause of death in the U.S., creates complex medical and psychosocial challenges. Individuals with liver disease, their caregivers, and their clinicians may be affected by this illness, and at risk for challenging grief experiences. However, grief in chronic liver disease has been underexplored. The purpose of this narrative review was to examine the grief experiences of adults with chronic liver disease, their caregivers, and their clinicians. Embase, Medline, Web of Science, CINAHL, PsycINFO, and Social Sciences online databases were searched resulting in a total of 11 included articles. 12 themes emerged capturing the unique grief in chronic liver disease: seven themes pertaining to observations of grief; including wide-ranging emotions, multifaceted losses and social isolation, unique patient age profile, stage of life, and intersections with substance use, stigma, (prognostic) uncertainty, unique caregiver burden and grief, and the need for quality palliative and/or end-of-life care, and five themes pertaining to interventions in grief; including the role and benefit of palliative care, advance care planning, interdisciplinary support, hospice, and other strategies. Findings highlight a need for interventions and further research to improve the grief experiences of people with chronic liver disease and their personal and professional caregivers.
This study was conducted to clarify the practical characteristics of decision-making support in the form of advance care planning provided by care managers to clients with heart disease and dementia and to examine the impact of perceptions of multidisciplinary collaboration on such practices. A survey was conducted of care managers working for home-based care support agencies in Japan. Measures included advance care planning practice scales that were specific to each condition and a scale measuring collaboration with medical professionals. Factor analysis revealed that the content of advance care planning practice varies in relation to the characteristics of the given condition. For heart disease, the elements were emotional support and the understanding of values, while for dementia, the elements were information sharing with families and respect for each individual's strengths. Furthermore, multiple regression analysis indicated that perceptions regarding overall collaboration with healthcare professionals and predictions of future changes were common factors that promoted advance care planning practice in both disease groups. These findings indicated that promoting effective advance care planning requires an approach that is tailored to the characteristics of each disease and that strengthening interprofessional collaboration is key to supporting care managers' practice.
Access to palliative care for patients with chronic illnesses, including cancer, is essential. However, limited health system resources and reliance on charitable support in many countries have created service gaps. Volunteers can play a key role in bridging these gaps. This qualitative study explored the roles and responsibilities of volunteers in Iran's palliative care services. Semi-structured interviews were conducted with 12 stakeholders involved in volunteer-based palliative care, including policymakers/program managers, palliative care providers, community participation/public engagement experts, volunteers, and family caregivers. Data were analyzed using Graneheim and Lundman's approach with MAXQDA 20 software. The central theme identified was "Volunteers as the Missing Link in the Health System." Three main categories emerged: (1) facilitators of volunteer services, including perceived benefits for volunteers, patients, families, and the community; (2) management of volunteer services, encompassing infrastructure, planning, and leadership; and (3) outcomes of volunteering, including cultural promotion and invisible impacts. Volunteer involvement in palliative care may yield multidimensional benefits and foster a culture of participation. Effective management is essential to ensure structured and sustainable engagement. Stakeholders should prioritize the development of legal frameworks (Policies and Governmental or facility), standardized training, and organizational models to institutionalize volunteer participation in palliative care.
Online grief support has become a valuable resource for parents coping with the death of a child as it offers accessible and ongoing support during what is often a deeply challenging time. However, the specific content needs within these platforms remain underexplored. This study's purpose was to identify the types of content parents find most helpful in online grief support following the loss of a child. A total of 141 parents in Finland completed an online survey consisting of 62 Likert-scale questions related to their content preferences for grief interventions. The findings revealed that these parents sought information about grief and typical grief reactions, coping strategies, available support services, practical arrangements, self-assessment tools, and personalized content tailored to individual needs. They also expressed the importance of support that actively support coping and healing. Social work practictioners could use these findings in the design of multidisciplinary grief interventions that address the complex psychological, social, and spiritual needs of bereaved individuals and families.
Diabetes is often understood through blood sugar levels, dietary restriction, and medical discipline, yet it also shapes emotional life, bodily trust, shame, and daily social experience. This poem explores diabetes as an embodied and emotional condition, focusing on how food, numbers, wounds, and self-monitoring transform a person's relationship with the body. Through poetic reflection and everyday imagery, the poem uses sugar, measurement, meals, wounds, and bodily negotiation as metaphors for illness management, vulnerability, and the search for self-compassion. The poem highlights how diabetes can make ordinary acts such as eating, healing, and caring for oneself feel burdened by guilt, fear, and social judgment. It also emphasizes the need to view discipline not as moral failure or punishment, but as a form of survival and tenderness. By presenting diabetes through poetic expression, the work contributes to arts and health discussions on chronic illness, embodiment, dignity, health behavior, and compassionate self-care.
