The quilt pattern is a weaving together of a heart and kukui nut and leaves.

In seeking the appropriate theme of Kokua Mau to symbolize the work of the individuals and organizations involved, Kahu Wendell Kalanikapuaenui Silva (www.hawaiialohaspirit.com) was consulted to share his mana'o or wisdom. It would have to be something that embodied the vision of Kokua Mau - weaving a lei of community support so that Hawaii's people may die in the place of their choice, free of pain and suffering and treated according to their beliefs and values.

This was not the first involvement of Kahu Silva with Kokua Mau. After the Governor's Blue Ribbon Panel on Living and Dying with Dignity brought into public focus the need to improve end-of-life care in the state of Hawaii, a leadership team was formed to accomplish what the Panel recommended. Marilyn Seely, Director of the Hawaii Executive Office on Aging, approached Kahu Silva to create a name for the partnership of organizations that would set the goals of increased use of hospice, public and professional education, curriculum for faith-based communities on dying and bereavement, increasing the knowledge of and use of advance healthcare directives, and managing pain. He recommended the name "Kokua Mau", which means "continuous care." Care that would be sustained from birth to the golden years and finally, life's end.

His suggestions included the use of the kukui theme in the quilt block pattern. He shared that in Hawaii, one esoteric meaning of kukui nut is wisdom and enlightenment. Ancient Hawaiians used kukui nuts as candles, with their rich oil content - bringing light to the darkest time of the night. Kukui was also used as medicine.

It seemed appropriate to use the kukui nut symbolism, but add a heart motif, because the work of Kokua Mau is heart-centered and compassionate. Wisdom and compassion. Bringing light to a dark place, a place of taboo. Bill Moyers referred to death and dying as "America's final taboo."

Mary Cesar took the heart and kukui symbolism and created a quilt pattern, which Mike Nomura then simplified.

The kukui leaves and nuts seem to grow out of or radiate from the heart. It starts with compassion. Joanna Crocker, PhD, Kokua Mau's lead coordinator, grant writer and the heart and soul of Kokua Mau had a sign over her desk at Executive Office on Aging, "The heart is the only thing that never dies. We are eternally connected."

It all does come from the heart. Love is stronger than fear. With the kukui, the light of wisdom and enlightenment, growing out of the heart or from compassion, it shows that Kokua Mau's work is to enlighten and expand the work to improve end of life care. We are all one heart in this work. The heart is our inspiration, guide and unifying mystery, the Center, the Light in the Darkness.

The heroic people who work in hospice, pain management, palliative care and improving end-of-life care in general - are exactly what this logo is: true compassion and radiant heart energy reaching out in a nurturing way to bring wisdom to a dark place, and allow growth and "continuous care" until the final transition.

We are deeply grateful to Kahu Silva, Mary Cesar and Mike Nomura for the evolution of the Kokua Mau logo.