Family physicians are well-positioned to support both persons living with dementia (PLWD) and their caregivers. However, current electronic medical record (EMR) systems do not capture the relational and interdependent nature of dementia care. Dyadic data, linking the records of persons living with dementia (PLWD) and their caregivers, could support more integrated, proactive, and personalized care. While there is growing interest in leveraging EMRs for this purpose, few systems enable routine dyadic linkage, limiting clinical utility and research capacity.This report describes the current state of dyadic EMR data linkage in Canada, drawing on a pilot study using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). We examined methods for identifying PLWD-caregiver dyads in primary care settings, including manual identification and algorithmic approaches using shared contact information. Both methods were feasible, but each faced challenges related to EMR compatibility, privacy regulations, and consent processes. The study highlights how CPCSSN infrastructure can be used to create de-identified, longitudinal data sets for research and surveillance, while also identifying critical gaps that limit clinical application.Our findings demonstrate that while EMRs offer a promising platform for linking dyadic data, system-level changes are needed to fully integrate caregiver information into routine care. This includes standardized fields, clearer privacy guidelines, and cross-sector data harmonization. Dyadic EMR linkage has the potential to inform research, improve quality of care, and guide policy development. Future efforts must balance innovation with feasibility and privacy, ensuring caregiver roles are visible and valued within primary care systems.Abstract available in: يبرع (Arabic); Deutsch (German); Español (Spanish); Francais (French); हिन्दी (Hindi); Indonesia (Indonesian); (Chinese); (Japanese); Portugues (Portuguese).

In Japan, death from old age-rousui-is officially recognized on death certificates and is now the third leading cause of death. Rousui describes a gradual decline in physiological function leading to death without a specific underlying disease. As a family physician, my first diagnosis of rousui occurred two decades ago, for a woman in her 90s whose decline was slow, multidimensional, and free of reversible causes. While culturally accepted, rousui remains undefined in clinical terms, creating uncertainty in diagnosis and care. This ambiguity influences end-of-life decision making, sometimes leading to overmedicalization or undertreatment. As populations age globally, Japan's experience offers valuable lessons on how to recognize, document, and care for those dying from aging itself-inviting a broader discussion on aligning medicine with the natural trajectory of life's end.

Primary care clinicians are ideally suited to provide comprehensive, whole-person survivorship care for cancer survivors that focuses on managing co-occurring chronic conditions and mitigating risks related to the cancer and long-term effects of the disease and its treatment. It is therefore critical to develop and test innovative strategies to support primary care practices in delivering high-quality survivorship care. The National Cancer Institute-funded Primary Care Engaged Research for Cancer Survivorship Care (PERCS) initiative encompasses 4 randomized controlled trials funded by cooperative agreement (U01) grants that aim to develop and test primary care practice- and health system-level interventions to promote comprehensive survivorship care for adult cancer survivors during and/or after cancer treatment. Here, we outline the overall goals of the PERCS initiative, describe key features of each study, and explore opportunities for leveraging synergies and collaboration with the overall goal of improving care and outcomes for all survivors.

In this essay, the author highlights her difficult journey to breastfeed her son, discussing the physical, mental, monetary, and temporal difficulties faced by those who desire to breastfeed and offering recommendations for clinicians and society to make breastfeeding more attainable. Despite knowing breastfeeding can improve outcomes, even the author, a privileged and highly informed obstetrician and gynecologist, nearly could not afford the multiple, varied costs to breastfeed. Breastfeeding should not be a privilege, but an option accessible to all our patients.

On a rare day off from my duties as an ophthalmology resident, I wandered into a neighborhood bookstore and was recognized by a woman I had treated for optic neuritis in the emergency department. I didn't remember her, but she remembered everything. In that gap-between my routine and her life-altering night-I heard what the emergency department often muffles: how ordinary work for me can be extraordinary to the person living it. The piece follows our brief conversation to ask a simple question: how can I carry less and notice more, honoring meaning without slowing the work that must go on?