Loss of a patient quotes

Loss of a patient quotes DEFAULT
inspirational death quotes

Who knew that inspirational death quotes could be so beautiful? While many see death as a tragedy and horror, for some people, death is so much more than an end to life.

Perhaps the negative connotation of death comes from perceiving it from the eyes of those who have suffered losses. Nobody wants to lose the people they love. Nurses who have lost beloved patients can relate to this to a high degree.

Undeniably, death is hardest on the people who are left behind. But what is death for those who will do the passing?

Here are some death quotes that will make you think twice about the aspect of death.

1. &#;As a well spent day brings happy sleep, so life well used brings happy death.&#; &#; Leonardo DaVinci

leonardo da vinci inspirational death quotes

2. “Nurses are there when the last breath is taken and nurses are there when the first breath is taken. Although it is more enjoyable to celebrate the birth, it is just as important to comfort in death.” -Christine Bell

nurse death quote

Also Read: 50 Nursing Quotes To Inspire and Brighten Your Day

3. &#;Death &#; the last voyage, the longest and the best.&#; &#; Thomas Wolfe

DEATH QUOTES

4. &#;When the heart weeps for what it has lost, the soul laughs for what it has found.&#; &#; Sufi aphorism

Death quotes inspirational

5. &#;I think of death as some delightful journey that I shall take when all my tasks are done.&#; &#; Ella Wheeler Wilcox

death quotes that inspire

Also Read: How Do Nurses Deal With Death &#; 10 Advice from Fellow Nurses

6. &#;Have no regrets. The elderly usually don&#;t have regrets for what we did, but rather for things we did not do. The only people who fear death are those with regrets.&#; &#; unknown

ELDERLY DEATH QUOTES

7. &#;Perhaps they are not stars but rather openings in heaven where the love of our lost ones pours through and shines down upon us to let us know they are happy.&#; &#; Eskimo Proverb

eskimo proverb insprational death quotes

8. &#;Death is no more than passing from one room into another. But there&#;s a difference for me, you now. Because in the other room, I shall be able to see.&#; &#; Helen Keller

helen keller quotes

9. &#;He who has gone, so we but cherish his memory, abides with us, more potent, nay, more present than the living man.&#; &#; Antoine de Saint-Exupéry

inspirational death quotes antoine de saint exupery

&#;Die happily and look forward to taking up a new and better form. Like the sun, only when you set in the west can you rise in the east.&#; &#; Rumi

DEATH INSPIRATION

&#;When you were born, you cried and the world rejoiced. Live your life in a manner so that when you die the world cries and you rejoice.&#; &#; Native American Proverb

native american quotes on death

&#;The fear of death follows from the fear of life. A man who lives fully is prepared to die at any time.” &#; Mark Twain

MARK TWAIN DEATH QUOTES

&#;It&#;s strange that they fear death. Life hurts a lot more than death. At the point of death, the pain is over.&#; &#; Jim Morrison

inspirational death quote

 &#;Death came with friendly care; The opening bud to heaven conveyed, And bade it blossom there.&#; &#; Samuel Taylor

Inspirational Quote Death

 &#;Seeing death as the end of life is like seeing the horizon as the end of the ocean.&#; &#; David Searls

quotes about death

 &#;Somebody should tell us, right at the start of our lives, that we are dying. Then we might live life to the limit, every minute of every day. Do it! I say. Whatever you want to do, do it now! There are only so many tomorrows.&#; &#; Pope Paul VI

Inspirational quotes

&#;How can the dead be truly dead when they still live in the souls of those who are left behind?&#; &#; Carson McCullers

carson mccullers inspirational death quotes

&#;Death is not the opposite of life, but a part of it.&#; &#; Haruki Murakami

haruki murakami inspirational death quotes

&#;Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming &#;Wow! What a Ride!&#;.&#; &#; Hunter S. Thompson

hunter thompson inspirational death quotes

&#;Tell your friend that in his death, a part of you dies and goes with him. Wherever he goes, you also go. He will not be alone.&#; &#; Jiddu Krishnamurti

inspirational death quotations

 &#;Death is not the end of life; it is the beginning of an eternal journey.&#; &#; Debasish Mridha

inspirational death quote journey

 &#;Death is nothing else but going home to God, the bond of love will be unbroken for all eternity.&#; &#; Mother Teresa

inspirational death quote

 &#;Death is a challenge. It tells us not to waste time. It tells us to tell each other right now that we love each other.&#; &#; Leo Buscaglia

inspiring death quotes

&#;To the well-organized mind, death is but the next great adventure.&#; &#; J.K. Rowling

j k rowling inspirational death quotes

 &#;End? No, the journey doesn&#;t end here. Death is just another path, one that we all must take. The grey rain-curtain of this world rolls back, and all turns to silver glass, and then you see it.&#; &#; J.R.R. Tolkien

j r r tolkien inspirational death quotes

 &#;Death never takes the wise man by surprise, he is always ready to go.&#; &#; Jean de La Fontaine

jean de la fontaine inspirational death quotes

 &#;For what is it to die but to stand naked in the wind and to melt into the sun? And when the earth shall claim your limbs, then shall you truly dance.&#; &#; Kahlil Gibran

kahlil gibran inspirational death quotes

 &#;It is not death that a man should fear, but he should fear never beginning to live.&#; &#; Marcus Aurelius

marcus aurelius inspirational death quotes

 &#;Death is the destination we all share. No one has ever escaped it. And that is as it should be because death is very likely the single best invention of life. It is life&#;s change agent, it clears out the old to make way for the new.&#; &#; Steve Jobs

steve jobs inspirational death quotes

&#;Death is peaceful, life is harder.&#; &#; Stephenie Meyer, Twilight

death quotes

Death means many things to many people. If you came on here to seek comfort and inspiration, we hope that we have provided it.

Do drop by our FB page or Instagram. We&#;d love to hear from you!

Mary

Sours: https://www.nursebuff.com/inspirational-death-quotes/

Sympathy Quotes and Sayings

Sending a sympathy card or expressing your condolences can be hard when you’re at a loss for words. It’s never easy finding the right message to convey your emotions when a loved one endures a difficult time period or the loss of a loved one. However, expressing your sympathy and letting your friend or family member know that they can count on you is a necessary gesture. You can use sympathy quotes or condolence messages when sending your heartfelt sympathy card or memorial gifts. The following sympathy quotes will help guide your words that remind the recipient of your love and support.

Jump to:

heartfelt sympathy card with custom message

Sympathy Quotes For Loss

The following sympathy quotes for loss make heartfelt messages for most recipients. And if you’re looking for additional messaging, look to our family quotes or Miss You Dad quotes and messages.

  • “The Remembrance of the good done those we have loved is the only consolation when we have lost them.” – Demoustier
  • “Those we love and lose are always connected by heartstrings into infinity.” – Terri Guillemets
  • “You can’t truly heal from a loss until you allow yourself to really FEEL the loss.” – Mandy Hale
  • “And then I heard the angel say, ‘She’s with you every day.’” – Author Unknown
  • “The sun, the moon, the wind, the stars, will forever be around, reminding you of the love you shared, and the peace she’s finally found.” – Author Unknown
  • “Once upon a memory someone wiped away a tear, held me close and loved me, Thank you, dear.” – Author Unknown
  • “Say not in grief ‘he is no more’ but in thankfulness that he was.” – Hebrew Proverb
  • “As long as I can I will look at this world for both of us, as long as I can, I will laugh with the birds, I will sing with the flowers, I will pray to the stars, for both of us.” – Author Unknown
  • “The object is not to forget, but to remember to go on.” – Author Unknown
  • “Those we have held in our arms for a short while we hold in our hearts forever.”  – Author Unknown
  • “Our joys will be greater, our love will be deeper, our life will be fuller because we shared your moment.” – Author Unknown
  • “Do not think of me as gone.  I am with you still in each new dawn.” – Native American Poem

Short Sympathy Quotes and Sympathy Sayings

When sending a sympathy card, it’s important to remember that the individual who’s grieving may not want to read a long message. You should always avoid talking too much about yourself when writing your message, in addition to staying clear of notes that say, “I know how you feel”. The grieving process is an individual one and often times most recipients of sympathy cards and sympathy gifts don’t want any “fluff”. You can choose a short and meaningful condolence message or quote to share your sentiment when in doubt of what to say. Craft a complete sympathy message by pairing any of these short sympathy sayings with a lovely memory of the deceased and a specific offer of how you can help in their time of need, or use the following to build a memorial shadow box or tribute photo book for the grieving family.

Side view of two sad good friends embracing in a bedroom in a house interior with a dark light in the background

  • “Gone from our sight, but never from our hearts.”
  • “Our thoughts and prayers are with you.”
  • “I wish you healing and peace.”
  • “I hope you feel surrounded by much love.”
  • “We are so sorry for your loss.”
  • “We are thinking of you during these difficult times.”
  • “May my condolences bring you comfort and may my prayers ease the pain of this loss.”
  • “We pray the love for the lost is forever carried in your memory.”
  • “Words can’t express how saddened we are to hear of your loss.”
  • “May the memory of [insert name] bring you comfort and peace.”
  • “Today and always, may loving memories bring you peace, comfort, and strength.”
  • “My heart is with you in your time of sorrow.”
  • “Wishing you peace and strength during this difficult time.”
  • “May the sorrow you feel in your heart lighten by the love that surrounds you.”
  • “I’m missing [insert name] along with you. With heartfelt condolences.”
  • “Please accept my heartfelt sympathies for your loss.”
  • “I am sending you this card to let you know that I am thinking of you. I am sorry for your loss.”
  • “We are here for you and your family, now and forever.”

Famous Sympathy Card Quotes

Using a sympathy quote in your card is another way to express your emotions and remind the recipient that there’s hope. Poets, great figures, and novelists have laid the groundwork for sympathy messaging and it’s appropriate to use any of these quotes when expressing your condolences.

  • “What is lovely never dies, but passes into another loveliness, Star-dust or sea-foam, Flower or winged air.” – Thomas Bailey Aldrich
  • “What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.” – Helen Keller
  • “Only a moment you stayed, but what an imprint your footprints have left on our hearts.” -Dorothy Ferguson
  • “He spoke well who said that graves are the footprints of angels.” – Henry Wadsworth Longfellow
  • “A great soul serves everyone all the time. A great soul never dies. It brings us together again and again.” – Maya Angelou
  • “If I had a flower for every time I thought of you, I could walk in my garden forever.” – Alfred Lord Tennyson
  • “Unable are the loved to die, for love is immortality.” – Emily Dickinson
  • “There are no goodbyes for us. Wherever you are, you will always be in my heart.” – Mahatma Gandhi
  • “Like a bird singing in the rain, let grateful memories survive in time of sorrow.” – Robert Louis Stevenson

Religious Sympathy Quotes And Verses

If you share a religious bond with your friend or loved one, try using a religious sympathy quote or Bible verse to send a little light their way. Religious sympathy quotes and verses are often comforting and serve as a source of strength and unconditional love. In addition to bible verses, you can also write your own religious saying for a heartfelt message or look to our bible verses about family resource.

sympathy flower arrangement

  • “Never will I leave you; never will I forsake you.” Hebrews
  • “Blessed are those who mourn, for they shall be comforted.” Matthew
  • “For it is you who light my lamp; the LORD my God lightens my darkness.” Psalms
  • “Come to Me, all who are weary and heavy-laden, and I will give you rest.” Matthew
  • “God is our refuge and strength, a very present help in trouble.” Psalm
  • “And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” Philemon
  • “Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.” Isaiah
  • “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you.” – Isaiah
  • “We pray the love of God enfolds you during your journey through grief. We send you thoughts of comfort.”
  • “May the love of God heal you as the burden in your heart abounds.” -Unknown
  • “May you take comfort in knowing there is one more angel above us.” -Unknown

Words Of Sympathy

If you’re looking for different ways of expressing your sympathy, or you feel that word repetition is taking away from the meaning of your letter, consider the alternative words of sympathy below.

  • Sympathy
  • Condolence
  • Affinity
  • Compassion
  • Empathy
  • Kindness
  • Sensitivity
  • Understanding
  • Unity
  • Warmth
  • Consolation
  • Solace
  • Comfort
  • Commiseration

Show Appreciation for Essential Workers with Thank You Cards

Share your gratitude to essential workers during the coronavirus pandemic with an artistic thank you note. Decorate creative thank you cards and artwork with your kids that can be sent to hospitals and clinics or displayed outside your home. To show your family&#;s appreciation, share your child’s artwork with the hashtag #CreateThanks. Shutterfly will transform their creative works of art into thank you cards and posters and deliver them to essential organizations. Find more information and check out the #CreateThanks digital gallery here.

Resources related to Sympathy Quotes

Your comfort, time, and care, will never be forgotten after reaching out to a loved one who is grieving. Sympathy quotes and messages can go a long way and aid in making life a little bit easier for the recipient. Do your best to communicate and lend a few kind words. For specific tips on writing sympathy card notes for the loss of a mother, loss of a father, loss of a spouse, funeral flower cards, and more, visit our comprehensive article on what to write in a sympathy card.

And if you’re looking for additional resources with content related to sympathy quotes, see the guides below:

Sours: https://www.shutterfly.com/ideas/sympathy-quotes-and-sayings/
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  3. 2012 jeep wrangler oil pump

Looking for inspiring sympathy quotes for loss or pictures, images? Check out our collection of Top sayings on sympathy, condolence. We’ve divided it into two parts: 1) quotes with images 2) popular phrases without images.

Inspiring Sympathy Quotes

1. “It’s hard to forget someone who gave you so much to remember.”

Sympathy Quotes Condolence

2. “Perhaps they are not stars in the sky but rather openings where our loved ones shine down to let us know they are happy.”

Sympathy Quotes Condolence

3. “With Sympathy. Words can’t wipe away your tears. Hugs won’t ease your pain. But hold on to your memories. Forever they’ll remain.”

Sympathy Quotes Condolence

4. “Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.”

Sympathy Quotes Condolence

5. “Those we love don’t go away, they walk beside us everyday.” – Unknown

Sympathy Quotes Condolence

6. “After a loved one passes, be encouraged by their passing and legacy. Instead of crying, live an inspired, spiritual and happy life like they did when they were here. Live each day with encouragement knowing that they are proud and smiling down on you from Heaven”

Sympathy Quotes Condolence

7. “Sometimes the strongest people in the morning are the people who cried all night.”

Sympathy Quotes Condolence

8. “Memories… let them fill your mind, warm your heart, and lead you through.”

Sympathy Quotes Condolence

9. “Those we love can never be more than a thought away, for as long as there’s a memory they live in our hearts to stay.”

Sympathy Quotes Condolence

“A family is a circle of love, not broken by a loss, but made stronger by the memories. We are forever blessed that God connected us to you.”

Sympathy Quotes Condolence

“Death leaves a heartache no one can heal, love leaves a memory no one can steal.”

Sympathy Quotes Condolence

“The loss is unmeasurable but so is the love left behind.”

Sympathy Quotes Condolence

“Relationships can be strengthened through the veil with people we know and love. That is done by our determined effort to continually do what is right. We can strengthen our relationship with the departed individual we love by recognizing that the separation is temporary and that covenants made in the temple are eternal. When consistently obeyed, such covenants assure the eternal realization of the promises inherent in them.”

Sympathy Quotes Condolence

“When someone you love becomes a memory, the memory becomes a treasure.”

Sympathy Quotes Condolence

“Friends are the pillars on your porch. Sometimes they hold you up, sometimes they lean on you.”

Sympathy Quotes Condolence

“When you lose someone you love, you gain an angel you know.”

Sympathy Quotes Condolence

“No person is every truly alone. Those who live no more, whom we loved, Echo still within our thoughts, our words, our hearts.”

Sympathy Quotes Condolence

“What is lovely never dies, but passes into other loveliness.”

Sympathy Quotes Condolence

“With sympathy, thinking of you at this sad time and sending love.”

Sympathy Quotes Condolence

“Words, however kind, can’t mend your heartache, but those who care and share your loss wish you comfort and peace of mind. May you find strength in the love of family and in the warm embrace of friends.”
Sympathy Quotes Condolence

“We thought of you in love today, but that is nothing new. We thought about you yesterday and days before that, too. We think of you in silence, we often speak your name. Now all we have is memories and your picture in frame. Your memory is our keepsake, with which we’ll never part. God has you in his keeping, we have you in our hearts.”

Sympathy Quotes Condolence

“What we have once enjoyed we can never lose; all that we deeply love becomes a part of us.”

Sympathy Quotes Condolence

“Those we love and lose are always connected by heartstrings into infinity.”

Sympathy Quotes Condolence

“Your life was a blessing, your memory a treasure. You are loved beyond words and missed beyond measure.” – Renee Wood

Sympathy Quotes Condolence

“Death brings pain that time can only heal, no words could ease what we truly feel; but with God, her joy is eternally sealed, and cherish her memories that death can’t even steal. Lift up a smile for she is already in the paradise. Our deepest condolences.”

Sympathy Quotes Condolence

“He will cover you with his feathers, and under His wings you will find refuge.”

Sympathy Quotes Condolence

“God didn’t promise: days without pain, laughter without sorrow, nor sun without rain, but he did promise: strength for the day, comfort for the tears and light for the way.”

Sympathy Quotes Condolence

“Tenderly, may time heal your sorrow. Gently, may your friends ease your pain. Softly, may peace replace heartaches. And may warmest memories remain.”

Sympathy Quotes Condolence

“An Eternal memory until we meet again. Those special memories will always bring a smile if only I could have you back for just a little while. Then we could sit and talk again just like we used to do you always meant so very much and always will do too. The fact that you’re no longer here will always cause me pain but you’re forever in my heart until we meet again.”

Sympathy Quotes Condolence

“Those we love don’t go away, they walk beside us every day… unseen, unheard, but always near, still loved, still missed and very dear.”

Sympathy Quotes Condolence

“Sympathy does not think. It acts. It acts to remove the ceaseless sufferings of the world.” – Sri Chinmoy

Sympathy Quotes Condolence

“Words cannot express my sadness. May the comfort of God help you through this difficult time.”

Sympathy Quotes Condolence

“You may be gone from my sight… But you are never gone from my heart.”

Sympathy Quotes Condolence

“Gone is the face we loved so dear. Silent is the voice we loved to hear. Too far away for sight or speech. But not too far for thought to reach.”

Sympathy Quotes Condolence

“Losing a member if the family is never easy, especially one who offered such unconditional love.”

Sympathy Quotes Condolence

Sympathy & Condolence Quotes

“What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.” – Helen Keller

“There is no pain so great as the memory of joy in present grief.” – Aeschylus

“He spoke well who said that graves are the footprints of angels.” – Henry Wadsworth Longfellow

“Happiness is beneficial for the body, but it is grief that develops the powers of the mind.” – Marcel Proust

“Tears are the silent language of grief.” – Voltaire

“A great soul serves everyone all the time. A great soul never dies. It brings us together again and again.” – Maya Angelou

“There are no goodbyes for us. Wherever you are, you will always be in my heart.” – Mahatma Gandhi

“You can’t truly heal from a loss until you allow yourself to really FEEL the loss.” – Mandy Hale

“The heart forgets its sorrow and ache.” – James Russell Lowell

“No matter how prepared you think you are for the death of a loved one, it still comes as a shock, and it still hurts very deeply.” – Billy Graham

“Loss and possession, death and life are one, There falls no shadow where there shines no sun.” – Hilaire Belloc

“Like a bird singing in the rain, let grateful memories survive in time of sorrow” – Robert Louis Stevenson

“Grief changes shape, but it never ends.” – Keanu Reeves

“We should feel sorrow, but not sink under its oppression.” – Confucius

“When you speak of her, speak not with tears, for thoughts of her should not be sad. Let memories of the times you shared give you comfort, for her life was rich because of you.”

““The sun, the moon, the wind, the stars, will forever be around, reminding you of the love you shared, and the peace she’s finally found.”

“I am at a loss for words during this sorrowful time. Please know that I am thinking of you and praying for peace and comfort.”

“When sorrows come, they come not single spies, but in battalions.” – William Shakespeare

“The loss of a friend is like that of a limb; time may heal the anguish of the wound, but the loss cannot be repaired.” – Robert Southey

“When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.” – Khalil Gibran

“What is lovely never dies, But passes into other loveliness.” – Thomas Bailey Aldrich

“Our trials, our sorrows, and our grieves develop us.” – Orison Swett Marden

“I think loss of loved ones is the hardest blow in life.” – Marlo Thomas

“When you lose a person you love so much, surviving the loss is difficult.” – Cristiano Ronaldo

“There should be a sympathy with freedom, a desire to give it scope, founded not upon visionary ideas, but upon the long experience of many generations within the shores of this happy isle, that in freedom you lay the firmest foundations both of loyalty and order.” – William E. Gladstone

“And whoever walks a furlong without sympathy walks to his own funeral drest in his shroud.” – Walt Whitman

“Worry does not empty tomorrow of its sorrow. It empties today of its strength.” – Corrie Ten Boom

“Grief is the price we pay for love.” – Queen Elizabeth II


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Amy Finn

Hi. I'm Amy, the founder of this blog. I love quotes and enjoy sharing the best ones with you.

Sours: https://www.quoteambition.com/sympathy-condolence-quotes/
Wise Quotes

Here are 64 (Shhh! There are really 63) quotes about grief, coping and life after loss. Although we love a good grief quote, Litsa and I were slow to join in on the quote-pic phenomenon.  The Internet just seemed plastered with inspirational platitudes pasted on pictures of sunsets and rainbows. It all seemed so trite and reductive we decided not to add to the noise.  Then we got over ourselves.   A good quote serves many purposes.  A quote helps us put our own thoughts and feelings into perspective, it allows us to use the words of others to communicate or to convey a message, and it helps us to feel a sense of commonality when we find our feelings, experiences, and observations match those of another. We hope something here resonates with you and feel free to steal and share any of these images with your grieving family and friends. 

mix-tape

&#;The times you lived through, the people you shared those times with; Nothing brings it all to life like an old mix tape. It does a better job of storing up memories than actual brain tissue can do. Every mix tape tells a story. Put them together, and they can add up to the story of a life.&#;

~ Rob Sheffield, Love is a Mix Tape

thomas campbell

&#;To live in hearts we leave behind is not to die.&#;

~ Thomas Campbell

maya angelou

&#;When I think of death, and of late the idea has come with alarming frequency, I seem at peace with the idea that a day will dawn when I no longer be among those living in this valley of strange humors.

 

I can accept the idea of my own demise, but I am unable to accept the death of anyone else.

 

I find it impossible to let a friend or relative go into that country to no return.

 

Disbelief becomes my close companion, and anger follows in its wake.

 

I answer the heroic question &#;Death, where is thy sting?&#; with &#;It is here in my heart and mind and memories.'&#;

 

~ Maya Angelou, When I Think of Death


blue sky

&#;At the blueness of the skies and in the warmth of summer, we remember them.&#;

~ Sylvan Kamens & Rabbi Jack Reimer

prachett

&#;Do you not know that a man is not dead while his name is still spoken?&#;

~ Terry Pratchett


Ellis

&#;All the art of living lies in a fine mingling of letting go and holding on.&#;

 

~ Havelock Ellis

Barrie

&#;God gave us memory so that we might have roses in December.&#;

~ J.M. Barrie

Colette

&#;It&#;s so curious; One can resist tears and &#;behave&#; very well in the hardest hours of grief. But then someone makes you a friendly sign behind a window, or one notices that a flower that was in bud only yesterday has suddenly blossomed, or a letter slips from a drawer&#; and everything collapses.&#;

~ Colette

silverstein

&#;There are no happy endings. Endings are the saddest part, so just give me a happy middle and a very happy start.&#;

 

~ Shel Silverstein, Every Thing On It

 

 

kubler ross

&#;Should you shield the valleys from the windstorms, you would never see the beauty of their canyons.&#;

~ Elizabeth Kubler-Ross

carousel

&#;Walk on, walk on with hope in your heart and you&#;ll never walk alone.&#;

~ Rodgers and Hammerstein, Carousel


plath

 

&#;On this bald hill the new year hones its edge.

Faceless and pale as china

The round sky goes on minding its business.

Your absence is inconspicuous,

Nobody can tell what I lack.&#;

 

~ Sylvia Plath, Parliament Hill Fields

bradbury

&#;Everyone must leave something behind when he dies, my grandfather said. A child or a book or a painting or a house or a wall built of a pair of shoes made. Or a garden planted. Something your hand touches some way so your soul has somewhere to go when you die, and when people look at that tree or that flower you planted, you&#;re there.&#;

 

~ Ray Bradbury, Fahrenheit


we remember

 

&#;When we have joy we crave to share; We remember them.&#;

 

~ Sylvan Kamens & Rabbi Jack Riemer

 

thoreau

 

&#;Make the most of your regrets; Never smother your sorrow, but tend and cherish it &#;til it comes to have a separate and integral interest. To regret deeply is to live afresh.&#;

 

~ Henry David Thoreau

Untitled

 

&#;I&#;ll be seeing you

In all the old familiar places

That this heart of mine embraces

All day through.&#;

~ Billie Holiday, I&#;ll Be Seeing You

Untitled

&#;One more day

One more time

One more sunset, maybe I&#;d be satisfied

But then again

I know what it would do

Leave me wishing still, for one more day with you.&#;

~ Diamond Rio


TFIOS

 

&#;You gave me a forever within the numbered days&#;&#;

~ John Green, The Fault In Our Stars

Orourke

&#;I would always look for clues to her in books and poems, I realized. I would always search for the echoes of the lost person, the scraps of words and breath, the silken ties that say, &#;Look: She existed.'&#;

~ Meghan O&#;Rourke, Story&#;s End

 

silvberman

&#;14 years.

My longest relationship.

My only experience of maternal love.

My constant companon.

My best friend.

Duck.&#;

~ Sarah Silverman on her dog, Duck


___n

&#;Where you used to be,

there is a hole in the world,

which I find myself constantly walking around in the daytime,

and falling in at night.

I miss you like hell.&#;

~ Edna St. Vincent Millay

___n

&#;Look closely and you will see almost everyone carrying bags of cement on their shoulders.

That&#;s why it takes courage to get out of bed in the morning and climb into the day.&#;

~ Edward Hirsch

___n

 

&#;Losing my mother at such an early age is the scar of my soul. But I feel like it ultimately made me into the person I am today. I understand the journey of life. I had to go through what I did to be here.&#;

~ Mariska Hargity

___o

 

&#;My father didn&#;t tell me how to live; he lived, and let me watch him do it.&#;

~ Clarence Budington Kelland

 

___n

&#;No one ever told me that grief felt so like fear.&#;

~ C.S. Lewis

___n

 

&#;Ain&#;t no shame in holding on to grief&#; as long as you make room for other things too.&#;

~ &#;Bubbles,&#; The Wire


___n

&#;She was no longer wrestling with the grief, but could sit down with It as a lasting companion and make it a sharer in her thoughts.&#;

~ George Eliot

___n

&#;The holiest of holidays are those kept by ourselves in silence and apart: The secret anniversaries of the heart.&#;

~ Henry Wadsworth Longfellow

___n

&#;When a child dies, you bury the child in your heart.&#;

~ Korean Proverb

___n

&#;If I die before you

which is all but certain

then in the moment

before you will see me

become someone dead

in a transformation

as quick as a shooting star&#;s

I will cross over into you

and ask you to carry

not only your own memories

but mine too until you

too lie down and erase us

both together into oblivion.&#;

~ Galway Kinnell

___n

&#;It&#;s coming on Christmas

They&#;re cutting down trees

They&#;re putting up reindeer

And singing songs of joy and peace

Oh I wish I had a river I could skate away on.&#;

~ Joni Mitchell


___n

&#;Hope

Smiles from the threshold of the year to come,

Whispering &#;It will be happier&#;&#;&#;

~ Alfred Tennyson


___n

&#;When our days become dreary with low-hovering clouds of despair, and when our nights become darker than a thousand midnights, let us remember that there is a creative force in this universe, working to pull down the gigantic mountains of evil, a power that is able to make a way out of no way and transform dark yesterdays into bright tomorrows.&#;

~ Martin Luther King Jr.

___n

&#;When you die, it does not mean that you lose to cancer. You beat cancer by how you live, why you live, and in the manner in which you live.&#;

~ Stuart Scott

___n

&#;The deeper that sorrow carves into your being, the more joy you can contain.&#;

~ Khalil Gibran

___n

 

&#;Grief sucks.&#;

~ Everyone Ever

___n

&#;It takes strength to make your way through grief, to grab hold of life and let it pull you forward.&#;

~ Patti Davis

___n

&#;The healing power of even the most microscopic exchange with someone who knows in a flash precisely what you&#;re talking about because she experienced that thing too cannot be overestimated.&#;

~ Cheryl Strayed


___n

&#;What separates us from animals, what separates us from the chaos, is our ability to mourn people we&#;ve never met.&#;

~ David Levithan

have yourself a merry little christmas

&#;Someday soon, we all will be together

If the fates allow

Until then,

We&#;ll have to muddle through somehow.&#;


FI - impremanence

&#;No man ever steps in the same river twice, for it Is not the same river and he is not the same man.&#;

~ Heraclitus

disenfranchised grief 5

 

&#;Next person that minimizes my grief is getting a swift kick to the shin.&#;

 

master a grief

&#;Well, every one can master a grief but he that has it.&#;

~ William Shakespeare

&#;So when you need her touch

And loving gaze

Gone but not forgotten

Is the perfect phrase

Smiling from a star

That she makes glow

Trust she&#;s always there

Watching as you grow

Find her in the place

Where the lost things go.&#;

~ The Place Where Lost Things Go, Mary Poppin Returns

&#;If there ever comes a day where we can&#;t be together, keep me in your heart. I&#;ll stay there forever.&#;

~ A.A. Milne, Winnie the Pooh

 

&#;The whole world can become the enemy when you lose what you love.&#;

~ Kristina McMorris, Bridge of Scarlett Leaves

&#;Her absence is like the sky, spread over everything.&#;

~ C.S. Lewis, A Grief Observed

 

&#;I will not say: Do not week; For not all tears are evil.&#;

~ J.R.R. Tolkien, The Return of the King

 

&#;The reality is that you will grieve forever. You will not &#;get over&#; the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same nor would you want to.&#;

~ Elisabeth Kubler-Ross and David Kessler

 

&#;Give the sorrow words; the grief that does not speak knits up the o-er wrought heart and bids it break.&#;

~ William Shakespeare, Macbeth

&#;The song is ended, but the melody lingers on.&#;

~ Irving Berlin

 

&#;When he shall die,

Take him and cut him out in little stars,

And he will make the face of heaven so fine,

That all the world will be in love with night,

And pay no worship to the garish sun.&#;

~ William Shakespeare, Romeo and Juliet

 

&#;The boundaries which divide Life from Death are at best shadowy and vague. Who shall say where the one ends, and where the other begins?&#;

~ Edgar Allan Poe

 

&#;Sometimes, only one personn is missing, and the whole world seems depopulated.&#;

~ Alphonse de Lamartine, Méditations Poétiques

 

&#;Love is really the only thing we can possess, keep with us, and take with us.&#;

~ Elisabeth Kubler-Ross

 

&#;An abnormal reaction to an abnormal situation is normal behavior.&#;

~ Viktor E. Frankl, Man&#;s Search for Meaning

 

&#;Death ends a life, not a relationship.&#;

~ Mitch Albom, Tuesdays with Morrie

 

&#;But there was no need to be ashamed of tears, for tears bore witness that a man had the greatest of courage, the courage to suffer.&#;

~ Viktor E. Frankl, Man&#;s Search for Meaning

 

&#;They that love beyond the world cannot be separated by it. Death cannot kill what never dies.&#;

~ William Penn

 

 

&#;Life has to end.

Love doesn&#;t.&#;

~ Mitch Albom, The Five People You Meet in Heaven

 

&#;And once the storm is over you won&#;t remember you how made it through, how you managed to survive. You won&#;t even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won&#;t be the same person who walked in. That&#;s what the storm&#;s all about.&#;

~ Haruki Murakami, Kafka on the Shore

&#;What we once enjoyed and deeply loved we can never lose, for all that we love deeply becomes part of us.&#;

~ Helen Keller

Sours: https://whatsyourgrief.com/quotes-about-grief/

Patient a quotes of loss

Intersecting systemic and personal barriers to accessing social services: qualitative interviews in northern California

  • Research article
  • Open Access
  • Published:

BMC Public Healthvolume 21, Article number:  () Cite this article

Abstract

Background

Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks. This paper aims to describe patient-reported barriers to accessing and using social needs-related resources to which they are referred by a program embedded in a safety net primary care clinic.

Methods

This is a qualitative assessment of patient-reported barriers to accessing and using social needs assistance programs. We conducted over in-depth interviews with individuals in Northern California who participated in a navigation and referral program to help address their social needs and describe a unique framework for understanding how policies and systems intersect with an individual’s personal life circumstances.

Results

Individuals described two distinct domains of barriers: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal-level barriers that focused on unique limitations experienced by each patient and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity.

Conclusions

Respondents describe intersecting systemic and personal barriers that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. These findings highlight the need for advocacy to address systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between health care settings and social service agencies.

Peer Review reports

Background

Attending to the upstream and downstream impacts of social determinants of health in clinical settings is a critical component of improving the overall health and well-being of patients [1]. Most recently, the global COVID pandemic has further highlighted how social risks like housing instability, food instability, and access to healthcare impact exposure, testing, severity, and adequate treatment for coronavirus infection [2]. An assessment of programs designed to identify and support patients with unaddressed social needs have found that addressing social needs can lead to clinically meaningful improvements in outcomes like blood pressure and LDL-cholesterol [3]. More importantly, studies have found that addressing these social drivers of health in the clinical setting can increase patient confidence in the availability of community resources [3] and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts [4]. Healthcare organizations, especially primary and ambulatory care clinics, are increasingly adopting social needs screening and linkages to community-based and social service assistance programs to address social needs as a part of their core services. These programs typically involve baseline screening for social risks such as food insecurity, housing instability, lack of transportation, and utilities support with referral to programs that can help address identified needs. Referrals often link patients to programs outside a healthcare facility such as food pantries, utilities shutoff protections, or housing assistance programs, though in some settings they refer to assistance programs on-site, such as clinic-based food pantries or medical-legal partnerships. A recent paper described patient experiences with a screening and referral program, which provided key insights into how interactions with these programs impact patients both in terms of appropriateness of resource referrals and the establishment of a caring, therapeutic alliance [5]. However, that paper was unable to explore in depth the barriers those patients face when trying to connect to community resources.

We know that patients experience considerable barriers to accessing health-related services. For example, the American Hospital Association has laid out barriers to ensuring access to quality healthcare in vulnerable communities, including “limited federal funding, restrictive federal regulations, and a lack of collaboration and buy-in from community stakeholders” and indicates that “the most important resource may be hospital-community partnerships” [6]. Furthermore, disconnected relationships have been identified and described between clinical-community partnerships [7], and collaborative clinical-community partnerships are required to address patient social needs [8]. More work needs to be conducted to identify and describe barriers to accessing social needs-related services, especially when those needs are identified in a healthcare setting. To fill this gap and help to strengthen clinical-community partnerships, this paper is a deep dive into patient-reported barriers to accessing and using the social needs-related resources to which they are referred by a program embedded in a safety net primary care clinic. This analysis is based on over in-depth interviews with individuals in Northern California who participated in a program embedded in a county run primary care clinic to help address their social needs. We propose a framework for understanding how policies and systems intersect with an individual’s personal life circumstances based on the findings from these in-depth interviews. These intersecting barriers create a complex web that combine in ways that compound patients’ challenges to getting their social needs met. Better understanding the type and range of barriers individuals face opens the door for better assessment of these barriers and more targeted support to help overcome those barriers. These findings also highlight the need for advocacy to reduce the systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues and seeking assistance. These insights will help guide the design of policies and programs that are better able to address barriers patients experience when trying to seek assistance for social needs.

Methods

Interviewees participated in an intervention that was a collaboration between Contra Costa Health System (CCHS) and the nonprofit organization Health Leads. CCHS is located in Contra Costa County in northern California, which has a total population of million people [9]. The composition of the county’s population is % Hispanic individuals, % Asian/Pacific Islander and % African American; Hispanic individuals are the fastest growing ethnic group in the county [9]. West County Health Center (WCHC) is one of 11 health clinics run by CCHS to serve as safety net clinics for the Contra Costa County’s most vulnerable residents. In , WCHC provided more than , patient visits to the community across a variety of services including primary care, women’s health and specialty services. The intervention pilot embedded trained volunteer patient advocates in a large primary care clinic to help patients access community resources [10].

The Health Leads volunteer advocate model is well-documented [3, 5, 11]. Patients are referred to advocates based on responses to a paper screening tool developed by Health Leads to assess social needs [12]. Advocates conducted phone or in-person needs assessments and helped patients access resources. After initial encounters, advocates were expected to follow-up via phone, text, email or in person to determine if patients successfully accessed resources, needed help addressing barriers, and had additional needs. We conducted purposive sampling based on a set of characteristics we wanted to make sure we captured, implemented a stratified sampling plan, and included quotas based on two characteristics: 1) 50% of sample with > 1 successfully met needs, and 2) 30% Spanish speaking, defined as patient’s preferred language. We also prioritized three additional characteristics: 1) date of case closure, prioritizing more recently served patients to reduce recall bias, 2) number of social needs met, ensuring inclusion of patients with multiple needs, and 3) gender. Recruitment letters were sent starting with individuals who had the most recent experiences with the program in order to reduce recall bias. We had both addresses and phone numbers so we able to follow up with individuals even if they were not currently housed and had not received the letter. We followed informed consent protocols to ensure that participants understood the project and voluntarily consented to participate. A full description of our sampling strategy, recruitment, data collection and analysis procedures for the interview data has been published previously [5].

Selection criteria included: 1) enrolled in an intervention that is designed to screen for essential social needs and connect individuals to services between June –April , 2) had at least one closed need during that time interval (indicating that the advocate had completed their work with the patient, and either successfully or not successfully met the identified needs). Successfully met needs indicate that the patient reported successfully accessing resources in their community. We excluded patients who did not speak English or Spanish and who were under 18 years of age. Recruitment was designed to include respondents with key demographics similar to those in the Health Leads program [13].

The interview guide was a item guide designed to gather qualitative information from respondents about their experience working with advocates, including barriers experienced while trying to access resources in their communities, and if their needs were resolved (Appendix A). Semi-structured interviews were conducted via phone between July 1 and September 30, and averaged 15–30 min. Patients received $30 incentives by mail. Full description of data analysis has been described previously [5]. Interviews were coded using a thematic analysis approach. Coders developed an initial code list based on themes surfacing during review. All coders coded one transcript using the draft code list and compared their work. Codes were added, revised and clarified, repeating until all agreed the list was comprehensive. Each team member drafted sections of a master coding memo that was used to help summarize findings. Data were managed in Atlas.ti.

Results

We sent recruitment letters to patients, resulting in interviews with individuals, for a 37% response rate. Our population was 62% female (Table 1). Thirty-eight percent (38%) were between 50 and 65 years, and 35% were 30–49 years old. Per recruitment goals, 70% of the interviews were conducted in English and 30% were conducted in Spanish. A full description of the recruited and interviewed sample has been previously published [5].

Full size table

One overarching finding was that barriers clustered around two key domains: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal (individual)-level barriers that focused on unique limitations experienced by each patient who engaged with the Health Leads program and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity.

Systems-level barriers

Systems-level barriers were commonly cited as the reason patients did not access the services.

Table 2 lists themes described by patients along with individual quotes illustrating each theme, including the following:

Full size table

Limited availability

For a number of common social needs there were often not enough resources available. For example, housing is a common need that was often unavailable, especially in the Bay Area in Northern California, due to the limited options for safe and affordable housing.

Limited accessibility

Services were often difficult to access due to either distance or challenges getting through via phone or online. Individuals who were employed described difficulty accessing services outside of work hours. For individuals with transportation or mobility challenges, they described difficulty physically accessing services either because they could not get the transportation they needed to get to the service, or once there, could not gain access to the building due to mobility challenges.

I don't get around that well and the one [food pantry] I go to is really pretty far for me to walk. My only transportation is either my feet or a bicycle or public transportation out here. That's not convenient to these places because unfortunately I have to walk someplace to get a bus to take it there. Male, English, No success

Strict program criteria

Ineligibility for the service or resource because of income, health status, insurance status, lack of necessary documentation or identification, citizenship status, age or another program participation was a common barrier that patients encountered. An example of this is becoming ineligible for Supplemental Nutrition Assistance Program (SNAP) upon receiving disability benefits. Or, for instance, if an individual’s current income did not meet program requirements, they were ineligible for services. Respondents described feeling caught in a hole where they could not afford basic needs, for instance, but were also ineligible from getting assistance to help with those needs. Prior to June 1, , this was a very common barrier for many patients. Fortunately, starting June 1, in CA, people receiving Supplemental Security Income (SSI) can also apply for and receive CalFresh (SNAP) without impacting their SSI amount.

Complicated application processes

SNAP is a strong example of this, because it often includes a lengthy application, difficult questions, and multiple steps to complete.

Stigma

Perceptions of stigma associated with the necessary resource often kept respondents from accessing the resource. Respondents described feeling embarrassed to use some services due to the fact that those who access particular programs may be seen as low-income, incapable, or handicapped.

Lack of fluency in English and access to an interpreter

Language difficulties impacted how individuals could access resources; some respondents described feeling uncomfortable asking questions in English, particularly if English was their second language. Others described lack of adequate interpreter or translators which impacted how they could access services:

Sometimes in clinic or in the beginning they ask me if I need translator. Sometimes the translator, when they speak, I can't understand well what they're saying in French. I say sometimes okay, I can't understand. I try to understand, to talk to the person. Because their French is sometimes too difficult for me to understand. Female, English, Success

Immigration status and legal policies

This, coupled with lack of trust in institutions, impacted how individuals could access services. Services that require proof of citizenship are not only inaccessible to undocumented individuals but discouraged use of services by citizens with undocumented family members.

Personal-level barriers

Personal-level barriers were described by patients as preventing them from accessing the services or support they requested or were offered by Health Leads. The most common themes are illustrated in quotes shown in Table 3, including the following:

Full size table

Physical and mental health challenges

Individuals often described the ways that limitations imposed by health conditions posed a considerable barrier to getting their social needs met. This includes coping with symptoms of mental illness that made it difficult to engage with service organizations, chronic medical conditions like arthritis that causes severe pain, or acute medical conditions like injuries which made it difficult to find and access services to meet social needs.

Social isolation and lack of social support

Respondents described how living alone and/or lacking support from friends and family hampered their ability to access services. This barrier often interacted with physical health challenges since individuals with pain or limited mobility were dependent on others to accompany them places in order to access services. In addition, those without a driver’s license described feeling dependent on others to be able to access services:

I don't have a driver's licenseI have to wait when my daughter in law or my son, when they are available, but everybody is working. Saturday as you know, the county offices are closed, but the food pantries are open, so that is good. Female, English, Success

Lack of technology resources and computer illiteracy

Respondents without technology resources or who are computer illiterate described challenges to accessing services that were only accessible via the Internet.

Financial limitations

Respondents described having inadequate finances for the requested resource. For respondents with little income, they described challenges to accessing services that had financial costs associated with them, including issues requiring legal aid, or physical activity programs to help with chronic or acute pain or injuries.

Competing priorities

Respondents were often dealing with multiple personal- and systems-level barriers simultaneously and respondents reported that their need was not a high priority in comparison to other events or tasks that they were addressing.

Sometimes this was coupled with a lack of confidence that the resource would meet needs given past lived experiences or pressing new concerns. These comments also included the perception that the individual costs associated (time, effort) were too high to justify the anticipated reward, even when the reward was significant.

Our findings also indicated that there is a strong interrelationship between the systems and personal barriers patients encountered when presented with Health Leads resource referrals or attempting to access them. For example, a person with mobility issues (a personal barrier) might cite the distance of services from their home and limited public transportation as a challenge (a systems barrier):

“Well, my car broke down so I'm waiting to get my car fixed, because I haven't been able to do anything lately. My catalytic converter went out, and it's really expensive and so I'm just waiting to get enough money. It's sitting right in my driveway, stuck right in front of my front door. So I'm trying to get up the money to get that fixed. And then I can go out and do all the things that I want to do.” (Male, English, No success).

Other respondents describe health-related barriers that speak to the complexity of everyday life that can be difficult to navigate without personal resources like social support or financial resources:

“I remember telling them about some of my bills, they were past due and I wanted to see if they could help me, especially the water bill at that timeI knew I was going to need them, definitely, but not at that point. I was in the hospital probably every day. Blood work, blood pressure check up, MRI, so I didn't have time really to contact them or go to the clinic and look for them” Male, English, No success

Some of the respondents possessed behavioral, cognitive or developmental disabilities, and some described experiencing memory problems, social anxiety, and obsessive-compulsive disorders within the interview which made it difficult to work to access services:

“Because when you're dealing with emotional problems with doing practical things, if there's one more person leaning on you to get it done, it's not helpful for somebody like me. I don't know what the answer is to getting them to get it done - extreme consequences like losing Medicaid. Obviously I was willing to lose food stamps for two months rather than turn around and get the paperwork done.” (Female, English, No success)

For some, the need to access services to address social risks represented a loss of dignity. For others, stigmatized feelings were combined with a feeling of not wanting to “burden” the healthcare system or to take away resources from “more needy” patients/people. This was a key theme particularly identified among some Spanish speakers:

“And it does sound like a good amount of money, but no, my children said no. “No, mom, maybe other people who have a greater need than you can receive it.” For that reason, I did not do it. Because my children are supporting my husband and I with that.” Female, Spanish, Success

Sometimes interviewees lacked the capacity to articulate why they were unable to access resources. In other cases, respondents expressed confusion about the rules and regulations governing their benefits or who can access benefits from the organizations they were referred to, often large bureaucracies such as local or federal housing programs, county social services agencies, and public utilities.

Discussion

Our study found that there were two interwoven yet distinct domains of barriers. Systems barriers were pervasive and included adequacy and accessibility issues along with perceived issues of stigma and complex application and eligibility processes. Personal barriers included a host of problems taking priority over or complicating the ability for patients to access services to meet their needs including medical concerns, social isolation or lack of social support, fear of discrimination, or lack of technology literacy. Personal-level barriers compounded their difficulties accessing resources. Some resources—especially those related to legal aid, citizenship, and adult education —appear to have costs to patients, putting them out of reach for patients with little or no income. Patients reported physical health limitations or mental health conditions like depression that made meeting daily obligations challenging. Many of the interviewed patients often expressed the barriers they faced in ways that sounded like issues of prioritization: doing what was required to access resources—making phone calls, completing applications, going to new agencies—simply do not rise to the top of the list of things important to patients’ or their families’ well-being. Respondents described that demands of daily living are so challenging that mounting any extra effort seemed too difficult, if not impossible. Another interpretation of some of the patients’ descriptions speak to matters of self-efficacy or confidence. Patients were not certain that they could even do what the advocates advised, or if they did succeed, they expressed a lack of confidence that the resource would address their needs. While these problems may be relatively uncommon in the population overall, among the target audience for Health Leads they appear frequently.

With this in mind, a key finding from our analysis indicates that any program staff or volunteers hoping to engage patients struggling with personal barriers may benefit from additional training, triaging clients into special protocols for goal setting, action planning and monitoring. Patients may need more time with an advocate to overcome these barriers in order to successfully approach and resolve the resource need.

Our findings contribute substantially to reports from other studies assessing barriers to receiving clinical or social services. Similar to our findings, those studies report cultural, socioeconomic, and legal barriers [14, 15] as well as attitudinal barriers such as not wanting to involve outsiders in personal problems, not seeing the need for services, availability of services, language barriers or concerns about cultural appropriateness [16]. Other studies identifying barriers to accessing health and social services have reported high rates of self-reported access issues, and have identified that those reporting access issues were more likely to be socially and economically vulnerable or suffering from mental health conditions indicating that those who have the hardest time accessing services may be the most in need [17, 18]. Studies identifying how barriers to clinical and social services can be reduced use targeted social support interventions and specific navigation models to promote patient-centered health improvements [19] as well as strategies to evaluate local resources to develop partnerships and disease prevention interventions [20, 21]. Most studies raise the need to better understand “the relationship between perceived barriers to accessing services and dissatisfaction with services” [16] in order to promote health equity in our communities.

These results contribute substantially to the literature by describing the relationships between system- and personal-level barriers to accessing services among individuals experiencing social risks and engaged in an intervention to access services in their communities. Respondents describe intersecting systemic and personal barriers that combine in ways that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These findings also provide a framework for addressing both systemic and personal-level barriers to accessing social services in communicatees in northern California. Overall, our results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. More intentional investments are needed to better understand how to address the deep institutional, systemic, and personal issues that respondents describe. Based on the findings above, we recommend the following:

  • More investment in organizations focusing on building hospital/clinic-community partnerships in scalable ways. We need organizations committed to strengthen partnerships focused on providing whole person care including assessing the quality and quantity of local resources and investing in local networks and relationships. Some examples include organizations like 2– systems help promote the collaboration between public utility companies, housing organizations, food banks, and legal services (among others) [22], or Community Connect, Contra Costa County’s Whole Person Care Pilot program under the Waiver [23]. This program utilizes a multidisciplinary team that includes case managers from both Health and Social Services agencies to provide extended social needs case management services which includes counselling services through a relationship-based model that is trauma-informed and employs motivational-interviewing techniques to develop client prioritized care plans to connect individuals to resources in their communities and tracks patient-level outcomes over time to understand impact on utilization and overall health.

  • Better understanding of the competing priorities that make accessing services a low or negligent priority for some respondents. Results indicate that typically fewer than half of those who screen positive for social risk factors are interested in receiving assistance to help address identified risks [24, 25]. More analysis should be conducted to better understand if other priorities are more urgent in an individual’s current circumstances, or if there is a combination of barriers, perspectives, and experiences at play. Projects addressing this specifically are currently being led by researchers at UCSF, with support from the Robert Wood Johnson Foundation and Kaiser Permanente [26, 27].

  • Improved clinical incentives enabling program staff to engage with patients struggling with systems- or personal-level barriers to accessing social services. In this analysis, we describe a high-touch program that screens individuals for social needs, connects those who screen positive to services in their communities, and a system for longitudinal follow-up to better understand resolution of reported social needs. These programs take time and investment to operate successfully, and this can be difficult, or nearly impossible, in already overloaded clinical environments. Optimizing navigation programs (like the program that respondents in this paper participated in) requires continued investment in program staff and the time and space needed to build trusting relationships. Creating economic incentives for prevention and upstream investments in health encourage health plans and integrated health networks to invest in social interventions [28] which will enable program staff to improve care delivery for those struggling with social needs.

Limitations

Interviews, although asked in as supportive a manner as possible, were posed by strangers with no relationship to the patient. Asking patients to explain their internal thought processes in this context may make it hard for patients to be forthcoming; there may be embarrassment about not following through, a sentiment that patients expressed by blaming themselves for not making the effort or following their advocate’s suggestions. In addition, this study was limited to English and Spanish speakers. We were only able to speak with individuals who spoke English or Spanish, therefore we do not know if individuals who don’t speak either of these languages have more or different barriers. Other limitations include recruitment at a single health clinic in northern California, and a sample limited to participants who were reachable by telephone and consented to study participation. However, since the intervention occurred primarily over the phone and the vast majority of those who participated in the program had phones, it would have excluded very few program participants, if any.

Conclusions

Interviewers asked patients about anything that prevented them from accessing services or anything that the Health Leads advocates could have done to remove those barriers. What emerged included both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. While the program these individuals participated in made efforts to help address the social needs of individuals struggling with health issues, it was difficult to overcome the complex interrelationship of personal and systemic barriers. Understanding the range of barriers individuals face when trying to access resources for social needs calls for the need for more targeted support to help overcome those barriers. These findings also highlight the need for advocacy to address the systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between healthcare organizations and social service agencies.

Availability of data and materials

The data that support the findings of this study are available from Kaiser Permanente but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Kaiser Permanente.

Abbreviations

The name of the disease caused by the novel coronavirus SARS-CoV2

Low-density lipoprotein

Contra Costa Health System

West County Health Center

Supplemental Nutrition Assistance Program

Supplemental Security Income

University of California San Francisco

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Acknowledgements

We would like to acknowledge the individuals who provided their interview information in this manuscript, the Health Leads advocates who worked with these patients, and the providers at West County Health Center for their collaboration and support to make this study possible.

Funding

The pilot and evaluation were funded by the Kaiser Foundation Health Plan, Inc.

Author information

Affiliations

  1. Health Leads, San Francisco, CA, USA

    Hilary Placzek & Mary Carl

  2. Ariadne Labs, Boston, MA, USA

    Hilary Placzek

  3. Ontrak, Inc., San Francisco, CA, USA

    Hilary Placzek

  4. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    Stephanie Cruz & Clarissa Hsu

  5. Department of Anthropology, University of Washington, Seattle, WA, USA

    Michelle Chapdelaine

  6. Contra Costa Public Health Clinical Services, Martinez, CA, USA

    Sara Levin

Contributions

HP helped with study design, interpretation of results, and manuscript development. SC helped with study design, data collection, data analysis, and manuscript development. MC1 contributed to data collection, data analysis, and manuscript development. MC2 contributed to study design, interpretation of results, and manuscript development. SL contributed to study design, interpretation of results, and manuscript development. CH contributed to study design, data analysis, interpretation of results, and manuscript development. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hilary Placzek.

Ethics declarations

Ethics approval and consent to participate

Per the Human Subjects Review Office at Group Health Research Institute in Seattle, WA, this project did not meet the definition of human subject research per federal regulations (45 CFR 46), and this project did not need IRB review (reference #). We followed informed consent protocols to ensure that participants understood the project and voluntarily consented to participate and received verbal consent prior to initiating phone interviews.

Consent for publication

Not applicable since we did not include information that would identify an individual.

Competing interests

The authors of this article do not have any competing interests to disclose.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Patient Interview Guide

Patient Interview Guide

Health Leads Patient Interview Guide

  1. 1.

    Can you describe to me how you were introduced to the people in the blue shirts-the Health Leads advocates?

    PROBES:

    • Do you remember filling out any forms? What were your thoughts when you were asked to filling out the needs assessment form?

    • What did your doctor or any one on your doctor’s team tell you about the Health Leads program?

    • What was your reaction to being offered this service?

  2. 2.

    I’d like to know how you felt about the person or people you talked with, the advocate/person in the blue shirt at the clinic, or the person who called you to offer program services.

    PROBES:

  • How well do you feel they listened to you?

  • Do you feel they understood your life circumstances/what is going on in your life (for example what you could reasonably do and afford, or other barriers or challenges you faced)?

  • Overall, how comfortable were you talking with this person? What about them made you feel more or less comfortable?

  1. 3.

    Can you describe your first conversation with the Health Leads advocate?

    PROBES:

    • Did you talk to them when you were at the clinic? On the phone?

    • When you did talk with them was it at a convenient time?

    • What did you talk about with them?

    • Were the services the Health Leads person offered what you expected after talking with the doctor or health care team? (or below)

    • Did you have the time you needed to fully describe your needs?

    • Was there anything else they did or said during this first conversation that you found particularly helpful?

    • What, if anything, surprised you about the help they were offering?

  2. 4.

    [LOWER PRIORITY: ONLY ASK IF NOT COVERED IN QUESTIONS 3 AND YOU ARE NOT MORE THAN 20 MINUTES INTO THE INTERVIEW] What specific information did they give you about resources to contact?

    PROBES:

    • How did you feel about the resources they suggested? Did they make sense to you?

    • Had you heard of any of these resources before you worked with the Health Leads person>

    • Were the resources they offered what you expected? How were they different? (too far away, too expensive, not eligible for them, etc.)?

    • Were there other resources you needed help connecting with?

    • Did the help they provided give you any other ideas (or skills) that helped you address the issue you needed help with?

  3. 5.

    Did you try to contact the resources they suggested? Why or why not?

  4. 6.

    <If they attempted to contact> Can you tell me the story of/about what happened when you tried to contact the resource?

    PROBES:

  • <probe as needed to fully understand their experience with the resource>

  • Who contacted the resource?

  • What happened when you got ahold of the resource/service?

  • How were you treated?

  • Did they offer the services you thought they were going to offer?

  1. 7.

    What are the main barriers you came up against when trying to either contact or use the resources you were referred to?

  2. 8.

    Were there things that the Health Leads program could have done to make contacting the resource easier?

  3. 9.

    Did the Health Leads program follow up with you to see if you were able to get the resources you needed? If yes, can you describe that follow up call?

    PROBES:

    • Did you actually speak to someone?

    • What types of questions did they ask you?

    • Did they give you any additional information?

    • How useful did you feel this follow up call was?

    • How much follow up do you want from a program like Health Leads? Would you have liked them to follow up more? Less?

    • What time of day did they call you? Was this a convenient time for you? If not, what would have been more convenient?

  4. What is going on now with regard to your <name issue, i.e. housing situation, access to food >?

  5. What has changed as a result of working with the HL program?

    PROBES:

    • What, if anything, has changed with regard to your health as the result of working with the HL program (or that you would link to getting the resource you were referred to)?

    • Did the HL program give you any information or coaching that helped you feel better about your health? If so, what?

    • Did the HL program give you the confidence to reach out to other resources on your own? If so, can you tell me about that?

    • How, if at all, did your experience with the HL program change how you feel about your doctor and/or your doctor’s team?

    • What, if any, other changes occurred for you or your family as a result of working with the Health Leads program?

  6. Overall, how would you describe your feelings about the help you received from the HL program?

    PROBES:

    • How satisfied were you?

    • Would you use this service again? Why or why not?

    • Did you have any concerns about the services provided by the HL program?

    • How did you feel amount the amount of support they provided?

      1. i.

        Was it too much? Too little?

      2. ii.

        If too much, what would you have preferred they didn’t do?

      3. iii.

        If too little, what more could they have done to support you in getting resources or services?

    • How did you feel about receiving this service at your clinic/doctor’s office?

    • What did you like best about Health Leads program?

    • What could the Health Leads person or program have done better?

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Placzek, H., Cruz, S., Chapdelaine, M. et al. Intersecting systemic and personal barriers to accessing social services: qualitative interviews in northern California. BMC Public Health21, (). https://doi.org//s

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Keywords

  • Social determinants of health
  • Qualitative patient-reported interviews
  • Clinical navigation services for addressing social needs
  • Health and social service systems
  • Population health
Sours: https://bmcpublichealth.biomedcentral.com/articles//s
20 Quotes about Grief - Super Quotes - Inspirational Quotes

55 Sympathy Messages To Use In a Condolence Card

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Show up for a grieving friend or family member with one of these comforting messages.
couple holding hands and expressing sympathy

on September 28,

If you have a friend or family member who’s grieving, finding the right words to comfort them can be beyond tricky. While saying “I’m sorry” is a go-to when it comes to condolences, it can sometimes feel too impersonal when talking to a loved one who’s watched you ugly-cry while helping you finish off a tub of ice cream after a bad day. The same rule applies to someone you barely know (like a new co-worker or neighbor) — saying “I’m sorry” sometimes feels a little removed, like maybe you don’t really mean it even though you totally do. And then there’s the important question: What do you write in a sympathy card?

If you're struggling to find the right words to say, take comfort in the fact that you are not alone. Knowing how to provide sympathy is difficult for everyone, which is why we’ve rounded up some of the best quotes and sayings about sympathy to help you truly show up for the people around you. Whether you're looking for sympathy quotes for the loss of a mother or father or if you're in need of religious sympathy sayings, you're in luck. Read on.

Sympathy quotes for loss:
  • “Those we love don’t go away, they walk beside us everyday.” –Unknown
  • “As a well spent day brings happy sleep, so a life well spent brings happy death.” –Leonardo Da Vinci
  • “What is lovely never dies, But passes into other loveliness.” –Thomas Bailey Aldrich
  • “Across the years I will walk with you, in deep green forests, on shores of sand and when our time on earth is through, in heaven too, you will have my hand!” –Robert Sexton
  • “Darkness may hide the trees and the flowers from the eyes but it cannot hide love from the soul.” –Rumi
  • “No, the camera can’t steal the soul. But it can occasionally hold it hostage.” –Unknown
  • Sorrow is so easy to express and yet so hard to tell.” –Joni Mitchell
  • “May you take comfort in knowing there is one more angel above us.” –Unknown
  • “Grant but memory to us and we lose nothing by death.” –Whittier
  • “As we go through the journey of life, we must remember that the impressions we leave behind will define who and what we are. They are just as individual as the paths we have chosen to walk. So leave good impressions wherever you go.” –Dave Hedges
  • “There is no pain so great as the Memory of joy in present grief.” —Aeschylus
  • “Oh heart, if one should say to you that the soul perishes like the body, answer that the flower withers, but the seed remains. –Kahlil Gibran
  • “The Remembrance of the good done those we have loved is the only consolation when we have lost them.” –Demoustier
  • “What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.” —Helen Keller
  • “There are no goodbyes for us. Wherever you are, you will always be in my heart.” –Mahatma Gandhi
  • “Wishing you strength for today and hope for tomorrow.” –Renee O'neill
  • “It’s hard to forget someone who gave you so much to remember. –Unknown
  • “A mother’s grief is as timeless as her love.” —Joanne Cacciatore
  • “There is something about losing your mother that is permanent and inexpressible a wound that will never quite heal.”  –Susan Wiggs
  • “When I am lonely, I think of you and all that you brought to my life. Your memory rests gently on my soul." –Cindy Adkins
  • "To live in hearts we leave behind is not to die." –Thomas Campbell
  • “Grief never ends, but it changes. It’s a passage, not a place to stay. Grief is not a sign of weakness, nor a lack of faith. It is the price of love.” – Unknown
  • “Those we love and lose are always connected by heartstrings into infinity.” –Terri Guillemets
  • “How very softly you tiptoed into our world, almost silently, only a moment you stayed. But what an imprint your footsteps have left upon our hearts.” –Dorothy Ferguson
  • “The object is not to forget, but to remember to go on.” – Unknown
  • “What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.” –Helen Keller
  • “Grief is like the ocean; it comes on waves ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.” –Vicki Harrison
  • “There are some who bring a light so great to the world that even after they have gone, the light remains.” – Unknown
Religious sympathy quotes:
  • “Earth hath no sorrow that Heaven cannot heal.” –Thomas Moore
  • “May He who knows your sorrow bring peace, comfort, and healing to your soul.” – Unknown 
  • “Please know that I am praying for your peace and comfort.” – Unknown 
  • "For death is no more than a turning of us over from time to eternity." – William Penn
  • "When you lose someone you love, you gain an angel you know." —Unknown
  • “Blessed are those who mourn, for they shall be comforted.” – Matthew
  • “God is our refuge and strength, a very present help in trouble.” – Psalm
  • “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you.” – Isaiah
  • “Those we have held in our arms for a little while, we hold in our hearts forever.” – Unknown
  • “I am so sorry for your loss.” – Unknown
  • “We are with you through this difficult time.” – Unknown
  • “May the sorrow you feel in your heart lighten by the love that surrounds you.” – Unknown
  • “Hoping you feel surrounded by much love.” –Unknown
  • “Sending you my love and comfort. Deepest sympathies for your loss” – Unknown
  • “May loving memories ease your loss and bring you comfort.” – Unknown
  • “Gone but not forgotten.” – Unknown
  • "In the end, it's not the years in your life that count. It's the life in your years.” –Abraham Lincoln
  • "It is not length of life, but depth of life." – Ralph Waldo Emerson
  • “Everything will be okay in the end. If it’s not okay, it’s not the end.” – Unknown
Comforting sympathy quotes:
  • “Perhaps they are not stars, but rather openings in heaven where the love of our lost ones pours through and shines down upon us to let us know they are happy.” – Eskimo Proverb
  • “The sun, the moon, the wind, the stars, will forever be around, reminding you of the love you shared, and the peace she’s finally found.” – Unknown
  • "I know for certain that we never lose the people we love, even to death. They continue to participate in every act, thought and decision we make. Their love leaves an indelible imprint in our memories. We find comfort in knowing that our lives have been enriched by having shared their love." – Leo Buscaglia
  • "There are no goodbyes for us. Wherever you are, you will always be in my heart." – Mahatma Gandhi
  • “A great soul serves everyone all the time. A great soul never dies. It brings us together again and again.” – Maya Angelou
  • “May love be what you remember most.” – Darcie Sims
  • “When someone you love becomes a memory, the memory becomes a treasure.” – Unknown
  • “May you find comfort in loving memories, strength in the support of those who care, and hope in each new day.” – Unknown
Sours: https://chatbooks.com/blog/sympathy-quotes-sayings

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