GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. These articles are part of a new series called Clin-Star Corner , a new series in JAGS that reviews practice changing articles in the care of older adults. .

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. We also talk about the importance of a proactive approach to involving speech-language pathologists in the care of individuals early on with neurodegenerative diseases like dementia and ALS.

IT 124

IT Hospital Patient-Centered Individual 124

GeriPal

JUNE 8, 2023

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. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

JULY 19, 2024

What should we use to screen individuals? There’s an article about her in New York Times. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. Who should get it if anyone? What happens after they test positive? Anna 01:38 Yeah. So this is great.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MAY 11, 2023

But I would say that in terms of education, it’s really complicated because it’s so confounded by socioeconomic status and so many social determinants of health. Now, that doesn’t mean it’s a one-to-one, and this is very hard as we see it with our patients who have done all these things. This is Eric Widera.

Physicals 86

Physicals IT Hypertension Education 86

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. Rectal method is more appropriate for infants, children and unconscious or comatose patients who are not able to hold the thermometer in their mouth. Understanding the patient’s medical history is crucial for an accurate diagnosis. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

NOVEMBER 14, 2024

Patients may feel like falls are just part of normal aging. If you want to do a deeper dive into some of the articles we discuss, take a look at the following: An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults. I think both the patients feel that. A fall related injury.

IT 124

IT Patient-Centered Screening Community 124

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

The Clinical Problem Solvers

FEBRUARY 8, 2023

Between 2007 – 2019, Black individuals experienced a higher death rate for opioid overdose deaths than any other racial or ethnic group. These narratives have vilified individuals who would benefit from comprehensive, person-centered substance use treatment, rather than incarceration and other adverse harms.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

Medical Xpress

JUNE 16, 2025

In a study published in Nature Communications , led by researchers at National Taiwan University (NTU) and National Tsing Hua University (NTHU), scientists used the deepest-ever two-photon calcium imaging in awake mice to directly observe how individual SCN neurons respond to light. But what we observed was much more complicated."

Provider 109

Provider Complication Medical Diabetes 109

GeriPal

JANUARY 25, 2024

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? It used to be a much more complicated model. Lyndsay: Yes.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

Edge Family Medicine

OCTOBER 8, 2024

At Edge Family Medicine, we prioritize early detection to give our patients the best chance at a healthy life. By identifying health issues in their initial stages, patients can make informed decisions and act promptly. Edge Family Medicine offers high-quality, patient-focused care that centers on early detection and prevention.

Family Medicine 130

Family Medicine DO Screening Families 130

Medical Xpress

JUNE 16, 2025

Edwards edited by Gaby Clark , reviewed by Andrew Zinin Gaby Clark scientific editor Meet our editorial team Behind our editorial process Andrew Zinin lead editor Meet our editorial team Behind our editorial process Editors notes This article has been reviewed according to Science Xs editorial process and policies.

Mental Health 52

Mental Health IT Medical Specialization 52

GeriPal

MAY 26, 2022

This week, we discuss an article by bioethicists Govind Persad and Emily Largent arguing that the NIH guidance for allocation of Paxlovid during conditions of scarcity. And then tier two is unvaccinated individuals not included in tier one who are at risk for severe disease. What’s wrong with that? Why not prioritize them?

Vaccination 88

Vaccination Individual IT Healthcare 88

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis. This is Eric Widera. Alex 00:12 This is Alex Smith.

Management 116

Management Patient-Centered Patients IT 116

PEMBlog

JUNE 2, 2025

What you can expect to learn from this article: Recognize signs of end-organ injury when BP is 95th percentile + 30 mmHg. Upon entering the room, you find the patients nurse at the bedside already in mid-conversation with the patients parent. Use IV labetalol or nicardipine continuous drips to lower blood pressure.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

MARCH 9, 2023

Early data on efficacy in patients with anxiety and demoralization are promising. Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). Research is exploding. You’ve been trained?

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

Families 98

Families Family Patient-Centered IT 98

GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

FEBRUARY 8, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. BJ: Mm-hmm.

IT 137

IT Families Family Physicals 137

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Would you also just mind mentioning kind of the JPSM article too?

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. The article was titled, “ Change is coming ” – which also gives you a hint as to today’s song request. I probably should have said GFR. Eric: Yes. I just choose GFR.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Had multiple physical, psychological complications as a result of that.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MAY 25, 2023

Complicated grief? I’m not sure if you read that article and whether or not it’s changed your mind or whether or not you want to do any more research in advance care planning. And as you know, it’s a great article. Did the caregiver feel heard and understood? Did they have PTSD? Depression? Your thoughts?

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. What are the patients that we remember?

IT 83

IT Families Family Illness 83

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. So that could be symptoms in a patient with dementia, maybe some delirium and off.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

OCTOBER 19, 2023

Caveat as well that RCTs should not be placed on pedestal as the only answer- often patients enrolled in RCTs do not represent real world patients – observational studies do. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Families 106

Families Family IT Patients 106

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Clinicians were randomized to 4 groups: Usual care Prognosis nudge – EHR prompt asking, do you think your patient will be alive in 6 months?

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

GeriPal

MARCH 24, 2022

Start by reading this article by Sean Morrison, Diane Meier, and Bob Arnold in JAMA , and this response from Rebecca Sudore, Susan Hickman, and Anne Walling. Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

MARCH 7, 2024

Check out the Pub Crawl GeriPal post for more info, and follow #HPMParty on Twitter to keep us as we crawl! ** In the last several years, I’ve seen more and more articles about end-of-life doulas ( like this NY Times article from 2021 ). But in the end, I see these as my patients and I’m trying to define what is the right model.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. Dani and colleagues article on Palliative Care Psychiatry: Building Synergy Across the Spectrum. Oh, yeah, yeah. Good artist. Really tasteful.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

MARCH 30, 2023

Liz wrote a fabulous perspectives piece in the NEJM titled “ Deciding on My Dimples ” which talks about her experience as a patient doing shared decision making during neurosurgery for resection of an astrocytoma. But my piece in the New England Journal is about being a patient right before awake brain surgery. I could learn this.

IT 96

IT Patient-Centered Patients Healthcare 96

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96