The importance of addressing social determinants of health (SDH) in clinical practice is widely acknowledged. However, managing SDH becomes particularly challenging when patients exhibit psychological deficits and behavioral disorders. The present case involved a woman in her 80s who lived on public assistance and exhibited multiple co-morbidities. Following the initiation of home medical care, her condition deteriorated due to an interruption in necessary medical treatment after the electricity in her house was disconnected for nonpayment. The patient had strained relationships with the public assistance officer and other support personnel. As her primary physician, I convened all relevant parties to address the situation, evaluated her psychological and behavioral issues, and provided financial management support. Within six months, she paid her overdue electricity bill, following which her symptoms showed notable improvement. This report details the challenges healthcare workers face while addressing multiple SDHs such as the patient's financial hardship and severed connections with social resources. Our findings suggest that interventions tailored to a patient's psychological and behavioral needs improve their health.

Family issues are common in daily life, and the impact of illness and health on family has been researched in various contexts. In Japan's primary care settings, many patients face family problems. One approach proposed to address these issues is "family-oriented care." Family-oriented care is based on "systems theory" and "family therapy" and involves collaborations between family physicians and family therapists. Although several previous studies have discussed its practice and effectiveness, standardized training programs have yet to be established, leaving each facility to refine its approach through trial and error. Furthermore, limited literature exists on the current state of education in this field, making it difficult to grasp the overall landscape. This review article provides an overview of the current status of family-oriented care practice and education in Japan, compares it with advanced efforts in the U.S., and discusses challenges in standardizing education in Japan. Furthermore, we propose the development of a standardized education model for "Japanese-style family-oriented care," tailored to Japan's unique cultural context, customs, family dynamics, and societal structures.

Objective: This study aimed to conduct a narrative review of research on single caregiving to investigate the current status and challenges faced by single caregivers, identify their support needs, and examine these findings from both medical and nursing perspectives.

Method: A literature search of databases, including Igaku Chuo Zasshi and CiNii Article, was conducted to extract articles related to single caregiving. Fifteen articles were extracted and used to assess the situation of single caregivers and the required support.

Results: Single caregiving was based on a relationship with the cared-for person. The single caregiver had to balance caregiving with his or her lifestyle in a situation where there was no one else to take his or her place. Balancing work and caregiving was difficult, which led to economic and health problems. There were nine categories of support sought, including "improvement of work-life balance," "establishment of a comprehensive support system," "improvement of the working environment," and "support by medical and nursing personnel."

Conclusion: Balancing work and caregiving is important for single caregivers. Medical and nursing professionals must identify whether a caregiver is a single caregiver at an early stage, provide information that takes into account the history of relationships between family members, support the health of both the caregiver and the cared-for individual, and have a long-term perspective on assistance.

We conducted a document analysis to assess the presence of courses related to polypharmacy, their placement within the medical school curriculum, the responsible departments, and the allocated lecture hours across Japan's 82 medical schools. Using syllabi published on their websites, we identified relevant courses through syllabus searches and comprehensive manual reviews by researchers. Among these schools, 22 (26.8%) offered courses related to polypharmacy. Our findings suggest that undergraduate education on polypharmacy has not yet been widely implemented nationwide, highlighting the need for further promotion efforts. Developing effective educational strategies remains an important challenge for the future.