Core Viewpoint - Palliative care, particularly through the integration of medical social workers and volunteers, is evolving to provide more personalized and comprehensive support for patients and their families, enhancing the quality of life even in the final stages of life [1][8][10] Group 1: Development of Palliative Care - The implementation of the local standard "Palliative Care Service Specification" in Beijing in April 2025 emphasizes the inclusion of medical social workers in core service teams, promoting a collaborative model of care [1] - The palliative care team at Tsinghua University Beijing Tsinghua Changgung Hospital has evolved from specialized medical staff to a multidisciplinary collaboration, integrating social workers and volunteers for enhanced support [1][10] Group 2: Role of Medical Social Workers - Medical social workers are crucial in providing psychological support, repairing social relationships, and connecting families with community resources, thus facilitating personalized care approaches [1][8] - They play a vital role in addressing the emotional needs of both patients and families, helping them navigate the complexities of illness and end-of-life issues [8][9] Group 3: Volunteer Contributions - Volunteers are trained to provide various services, such as haircuts and music therapy, which significantly enhance the comfort and happiness of patients in palliative care [9] - The involvement of volunteers not only meets the practical needs of patients but also fosters a sense of community and support for both patients and their families [9] Group 4: Future of Palliative Care - There is an increasing demand for palliative care services, and the future will see an expansion of service areas, with community and home-based care becoming primary settings [10] - The development of more standards and guidelines based on practical experiences will aid in the training of palliative care professionals and improve service levels to meet diverse patient needs [10]

Core Points - The National Health Commission has revised the "Palliative Care Practice Guidelines (Trial)" issued in 2017, resulting in the "Palliative Care Practice Guidelines (2025 Edition)" to further promote the development of palliative care across regions [1] - The guidelines focus on a patient and family-centered approach for terminally ill patients, utilizing a multidisciplinary collaboration model [1] - Key areas addressed in the updated guidelines include pain and symptom control, comfort care, psychological, spiritual, and social support [1] Summary by Categories - **Guideline Revision** - The updated guidelines aim to standardize palliative care practices and provide a reference for local implementation [1] - The revision includes updates on symptom control, comfort care, psychological support, and humanistic care [1] - **Content Focus** - The guidelines emphasize the importance of pain and symptom management, comfort care, and comprehensive support for patients and families [1] - Specific areas such as assessment and observation points, treatment principles, nursing key points, support points, and precautions have been optimized and refined [1]

Core Insights - The article discusses the challenges and compromises in hospice care in China, emphasizing the struggle for dignity at the end of life within an imperfect system [1][7] - It highlights the increasing aging population in China and the associated healthcare challenges, particularly in end-of-life care [2][6] Group 1: Aging Population and Healthcare Challenges - China is experiencing an unprecedented aging era, characterized by a rapid increase in the elderly population and a rising average life expectancy [2] - As of 2018, the average life expectancy in China was 77 years, but the average healthy life expectancy was only 68.7 years, indicating that elderly individuals spend an average of 8.3 years living with illness [2] - The prevalence of chronic diseases such as cancer, diabetes, and neurological disorders is increasing, raising questions about health and medical care in the context of aging [2] Group 2: Hospice Care and Dignity - The concepts of "hospice care" and "end-of-life care" aim to help the elderly accept their reality and achieve a dignified death [5] - In the U.S., patients can choose hospice care if two physicians determine they have less than six months to live, allowing them to forgo curative treatments [5] - Recent legislative efforts in China, such as the Shenzhen Medical Regulations, have begun to address the need for advance directives, marking a step towards ensuring dignity in end-of-life care [6] Group 3: Cultural and Systemic Challenges - The practice of hospice care in China predates the establishment of formal systems for ensuring patients' rights to self-determination at the end of life [7] - The article raises critical questions about how patients perceive and advocate for their dignity in the current cultural and systemic context [7] - It emphasizes the need for a deeper understanding of the complexities and compromises involved in providing dignified end-of-life care, reflecting on the various personal needs and choices that arise in this context [8]

Group 1 - The article discusses the impact of war and trauma on individuals, focusing on the works of author Zhang Ling, who is also a hearing rehabilitation specialist. Her experiences with veterans have influenced her writing, particularly in her stories that explore the aftermath of war and personal loss [4][5]. - Zhang Ling's novella "Xiao Han Ri Fang Cheng Ye" portrays a female journalist visiting a veteran, revealing the contrast between the veteran's heroic past during the war and his current struggles with isolation and silence in old age [4]. - The second novella, "Yi Hu Ji," reflects on the COVID-19 pandemic, depicting two women from different backgrounds who find solace in each other's company while caring for a limping fox, symbolizing the search for connection in a changed world [5]. Group 2 - The book "Notes toward a Supreme Fiction" by Wallace Stevens is highlighted as a significant work in modernist poetry, emphasizing the role of poetry in creating meaning in a world lacking ultimate beliefs. Stevens proposes three principles for poetry: abstraction, change, and the provision of pleasure [8][9]. - The collection includes over 150 representative poems from Stevens' career, showcasing his rich imagination and philosophical depth, often drawing inspiration from everyday life [8][9]. Group 3 - "The Geographer Drank His Earth" by Alexei Ivanov is noted for its portrayal of post-Soviet Russian life, focusing on a former biologist turned geography teacher who navigates personal and societal challenges with humor and resilience [12][16]. - The novel reflects on the courage and humility required to maintain a "living soul" amidst life's adversities, emphasizing the importance of love and conscience in daily life [12][16]. Group 4 - "The Iron Industry and the Converging Network of the Han Dynasty" by Lin Yongchang explores how iron production was intertwined with the political and economic systems of the Han Dynasty, revealing its role in the empire's governance and social structure [17]. - The book discusses the significance of iron in creating a vast network of communication and logistics that connected various political and economic regions, highlighting the impact of iron production on the empire's stability and growth [17]. Group 5 - "The Silver-haired Ferryman" by Chen Hui examines the phenomenon of "old drifting," where elderly parents move to cities to support their children's families, shedding light on their daily lives and emotional struggles [19][20]. - The book analyzes the complex adjustments of the "old drifting" group in terms of parenting, family relationships, and personal identity, illustrating their role in the evolving family structure amid rapid urbanization [19][20]. Group 6 - "Facing the End of Life: Compromises and Harmonies in Hospital Palliative Care" discusses the challenges of palliative care in China, emphasizing the need for improved definitions and practices in end-of-life care [22][23]. - The book presents case studies that highlight the difficult choices faced by patients, families, and healthcare providers in the context of limited resources and traditional views on death [22][23]. Group 7 - "In the Age of Great Disasters" reflects on Japan's historical earthquakes and the societal responses to disaster recovery, emphasizing the tension between restoring the past and creating a better future [25]. - The author, who participated in post-disaster reconstruction efforts, outlines the phases of disaster response and the ideological conflicts surrounding recovery efforts [25]. Group 8 - "The Orchid Phenomenon" by Jim Endersby explores the cultural significance of orchids in Western history, linking them to themes of sexuality, death, and beauty [27][28]. - The book discusses the commercial popularity of orchids and their symbolic meanings throughout history, while also addressing the threats they face due to human activities [27][28].

Core Viewpoint - The Guangdong Provincial Health Commission has issued the "Guidelines for Palliative Care Services," marking the first provincial-level palliative care service guidelines in China, aimed at standardizing and enhancing palliative care practices in the province [1][4]. Group 1: Palliative Care Overview - Palliative care focuses on providing integrated care and humanistic support to terminally ill patients and their families, addressing physical, psychological, social, and spiritual needs to improve quality of life and ensure a dignified death [2][3]. - The demand for palliative care in Guangdong is urgent due to its large elderly population, with plans to implement pilot programs across all 21 cities in the province by 2024 [2]. Group 2: Implementation and Standards - The guidelines detail 13 service items, including symptom assessment and life expectancy evaluation, and provide tools and templates to assist frontline staff in delivering standardized palliative care [2][4]. - The guidelines emphasize treating patients as whole individuals, addressing not only physical symptoms but also psychological and emotional needs, and encouraging family involvement in care decisions [3]. Group 3: Future Development and Training - The guidelines aim to achieve county-level coverage of palliative care services, with plans to establish at least one palliative care unit in every county by 2027 [4]. - The provincial health commission will incorporate training on the guidelines into the elderly health service training programs, with specialized palliative care training planned for the following year to enhance staff competencies [4].

Core Insights - The article discusses the development and significance of palliative care in China, highlighting the personal journey of Yang Jie, who transitioned from a finance career to founding a palliative care organization [2][4][32] - Palliative care is defined as a multidisciplinary approach focused on providing comprehensive support to terminally ill patients and their families, aiming to alleviate suffering and improve the quality of life [3][4] - The increasing recognition and legislative support for palliative care in China, including the establishment of relevant policies by the National Health Commission, is emphasized [3][4] Group 1: Palliative Care Development - Yang Jie has been instrumental in promoting palliative care in China through the Chunmiao-Guanyuan Palliative Care Special Fund, which has been operational for nearly four years [2][4] - The organization has collaborated with several hospitals, providing over 1,500 cases of in-hospital palliative care management and more than 200 instances of home-based support and online consultations from 2022 to 2024 [2][3] - The role of medical social workers in palliative care is highlighted as crucial for effective patient support, with a push for more hospitals to establish such positions by 2025 [4][4] Group 2: Challenges and Opportunities - Despite the growing interest in palliative care, there remains a significant gap in home-based services, which Yang Jie believes could fulfill many patients' wishes and reduce healthcare costs [4][4] - The article notes the challenges in fundraising for palliative care services, as the nature of the work often does not provide immediate feedback to donors [11][12] - Yang Jie emphasizes the need for a sustainable model that combines philanthropy and business to ensure the longevity of palliative care services [23][30] Group 3: Societal Perspectives on Death - The article discusses the general reluctance of the Chinese public to confront the topic of death, leading to a lack of preparation for terminal situations [14][15] - Yang Jie reflects on the societal need for better education and openness regarding death, suggesting that younger generations are more willing to engage in discussions about mortality [31][32] - The importance of addressing emotional and psychological aspects of dying for both patients and their families is underscored, as many experience feelings of regret and unpreparedness [28][29]

Core Insights - The annual college entrance examination has concluded, and over 13 million candidates will soon choose their majors, with increasing interest in the elderly care industry due to its high employment rates and future growth potential [1] - The National Health Commission predicts that China will enter a severe aging phase around 2035, indicating a growing demand for professionals in elderly care [1] Group 1: Industry Potential - The elderly care market in China has significant potential, with a projected increase in demand for related professionals over the next decade [1] - Currently, there are only 2 million elderly care workers in China, while the actual demand is estimated to be as high as 30 million [17] Group 2: Professional Experiences - Students in elderly care programs report a stark contrast between their expectations and the realities of the job, including physical and emotional challenges [6][15] - Many students initially face stigma or embarrassment about choosing elderly care as a profession, with a significant number considering changing their majors [15] Group 3: Educational Structure - The elderly care curriculum includes practical courses on elderly health assessment, emergency care, and communication skills, but many instructors lack specific backgrounds in elderly care [13][36] - Newer programs are evolving to meet the demands of the industry, such as the shift towards "Smart Health and Elderly Care Services and Management" [19] Group 4: Job Market and Opportunities - The job market for elderly care professionals is expanding, with various roles beyond caregiving, including management and research positions [36][33] - There is a growing recognition of the need for diverse skill sets in elderly care, including therapeutic recreation and social work [20][22] Group 5: Societal Perceptions - There is a societal stigma associated with elderly care roles, often viewed as low-status jobs, which can deter potential candidates [17] - The industry faces challenges in changing public perceptions and increasing the appeal of elderly care professions to younger generations [19][45]