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GeriPal Special: Hopes and Worries for Hospice and Palliative Care

GeriPal

“What we’ve seen to make it really work is you either have to be in the hospital, where we’ve taken over palliative care in the hospital, or you have to be contracted with managed care and get it at some kind of risk, because community-based palliative care is very difficult to make operate right now from a profitable [perspective].”

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Improving Hospital Care for Older Adults through Acute Care for Elders (ACE Units): Kellie Flood and Stephanie Rogers

GeriPal

Which patients are eligible to go to an ACE unit? If you want to do a deeper dive in ACE units, check out some of the following articles: The original NEJM paper on ACE units from 1996. So I picked the Ed Sheeran song, The A Team, because it reminds me of our ACE team that goes around the hospital and cares for our older patients.

Hospital 100
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Nurse Practitioners Critical in Treating Older Adults as Ranks of Geriatricians Shrink

Physician's Weekly

On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient’s home to the next, seeing eight in all. Forget a lunch break; she often eats a sandwich or some nuts as she heads to her next patient visit. “Our patient isn’t just the older adult,” Johnson said. “Hello.

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Diabetes in Late Life: Nadine Carter, Tamryn Gray, Alex Lee

GeriPal

When I’m on nursing home call, the most common page I receive is for a blood sugar value. When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. How high is too high? Should considerations differ for people with dementia?

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RCT of Palliative Care for Heart Failure and Lung Disease: David Bekelman and Lyndsay DeGroot

GeriPal

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. The article we discuss today, also published in JAMA , addresses these two gaps. Your research is a lot in this patient population, right? In their communities? Important implications.

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The Future of Geriatrics: A Podcast with Jerry Gurwitz, Ryan Chippendale, and Mike Harper

GeriPal

First, we’ve invited Jerry Gurwitz to talk about his recently published article in JAMA titled The Paradoxical Decline of Geriatric Medicine as a Profession (while it’s not the most upbeat title for the future of geriatrics, Jerry sees it as a call to action). I was going to start off by asking Jerry about why he wrote the JAMA article.

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Medical Cannabis Revisted: A Podcast with David Casarett and Eloise Theisen

GeriPal

If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. You got me laughing already.

Medical 98