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. This hasn’t floated into our hospital systems yet, but at least in the real world, people are using these to make insulin dosing decisions without needing to poke their fingers.

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. Panelists Kate Courtright and Scott Halpern have no relationships to disclose. and consulting for Papa Health.

Consulting 119

Consulting Hospital Patient-Centered IT 119

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. Today Liz Dzeng discusses her journey towards studying this issue in detail. So Liz, let’s jump into the topic.

Hospital 124

Hospital IT Patient-Centered Patients 124

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. But watch out! Alex 01:06 Yeah, go in person.

Telehealth 104

Telehealth Patient-Centered IT Patients 104

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. David: Right.

Patient-Centered 121

Patient-Centered Illness IT Patients 121

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? Should you stop at “no?” Eric: Lynn or Anne?

Families 97

Families Family Patient-Centered IT 97

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Families 111

Families Family Patient-Centered IT 111

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 114

Patient-Centered Illness Healthcare IT 114

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. hospice use). Tammie 02:56 It usually doesn’t work no matter what. So that’s great.

Patient-Centered 76

Patient-Centered IT Hospital Patients 76

GeriPal

FEBRUARY 13, 2025

We’re gonna be talking about three different articles that are gonna be presented Saturday, I believe, at the annual meeting. Three different articles. You did a rural tele-palliative care consultation study. And so the video consult was what became the mode. NCP guideline, standard consultation. Have to see.

Consulting 62

Consulting Community Patient-Centered Families 62

GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) Been in the hospital four times, vented, been told the story to her family, she won’t live. So those questions we ask when we’re doing a palliative care consult. Within the VA it’s now at 70 VA hospitals. Alex: Yeah.

IT 104

IT Patient-Centered Healthcare Illness 104

GeriPal

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. Did they ask for a consult?” We’ve got him.

IT 145

IT Hospital Patients Illness 145

GeriPal

JANUARY 16, 2025

I, for example, had one patient, I remember during my fellowship, I was in geriatrics clinic and had a very well read patient who came in and was reading a New York Times article, I think in the well section at one point. So those types of relationships, clergy, non family members, we talk about, I think cohabitating unmarried couples.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

GeriPal

JUNE 5, 2025

We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice. And so they’re in there for a very short time, couple weeks, get a little bit stronger and transition home after a hospitalization.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

MAY 12, 2022

He is also author of the book, “ Walk with the Weary: Lessons in Humanity in Health Care ,” and was featured in this Atlantic article. I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission.

Community 114

Community IT Relationship Healthcare 114

GeriPal

OCTOBER 5, 2023

We’ve invited Jacqueline Kruser and Bob Arnold on this week’s podcast to talk about their recently published JAMA Viewpoint article titled “ Reconsidering the Language of Serious Illness. ” You recently published an article in the New Yorker titled, I can’t even read my own, what was the title again? Of course not.

Illness 135

Illness IT Patient-Centered Families 135

GeriPal

FEBRUARY 27, 2025

I see this in the hospital when I’m doing addiction medicine consults. But that was my take home from Danny’s article. Alex 10:49 And then when you say accountability without termination, that sounds like it speaks to a core principle of palliative care around non abandonment and building relationships.

Patients 71

Patients Clinic Patient-Centered Illness 71

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. by Kearney. Lovely to be here.

IT 103

IT Patient-Centered Families Family 103

GeriPal

JANUARY 18, 2024

Panelists Katie Fitzgerald Jones and Jessica Merlin have no relationships to disclose. We got a couple of articles to discuss and a lot of different components of this. Eric: Which brings us to an article. laughter] Eric: Okay, Katie, we’ve got a lot to cover with substance use disorder. Jessie: Exactly. Should they?

Illness 135

Illness Patient-Centered Screening IT 135

GeriPal

NOVEMBER 21, 2024

Here are some more resources we’ve discussed in the podcast Dani’s NEJM article on coping: “ Should I Laugh at That? Alex 00:26 And we’re delayed to welcome Amanda Moment, who is a palliative care social worker at the Brigham and Women’s Hospital in Boston. Dani, welcome back to GeriPal. Dani 00:25 Excited to be back.

Illness 124

Illness IT Patient-Centered Families 124

GeriPal

JANUARY 20, 2023

But if you want to learn more, check out these links: The report by NASEM titled “ The National Imperative to Improve Nursing Home Quality ” The website for the Moving Forward We will also link to the JAGS articles co-authored by seven committee members that focus on specific recommendations of the NASEM report when they get published (stay tuned).

Finance 95

Finance Board-Certified IT Provider 95

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. And it kind of made its way into medicine probably around, I’m going to say the 50s after there was a fairly interesting Time Life article that was published. And when that article went to print, it just went ballistic. James, welcome to the GeriPal Podcast. Gordon Alwasa.

Illness 106

Illness IT Patient-Centered Patients 106

GeriPal

APRIL 24, 2025

We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Why did you even decide to write this article? For this weekly treatment, the cancer team that had been consulted in the hospital told him this is nonsense. I knew two things.

Patient-Centered 76

Patient-Centered IT Patients Illness 76

GeriPal

SEPTEMBER 5, 2024

And for this podcast in particular, both Bill and Louise wrote articles that we’re going to be discussing particular patient cases. So while you don’t have to, we’re gonna summarize these articles. If you have a chance to read those articles before you listen to this podcast, I highly recommend that you do.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

DECEMBER 5, 2024

– @AlexSmithMD Here’s a link to an article about the Palliative Story Exchange. ** This podcast is not CME eligible. Alex 00:40 We’re delighted to welcome Alexis Drutchas, who is a palliative care doc at the Massachusetts General Hospital and Harvard Medical School and co founder, also of the Palliative Story Exchange.

IT 106

IT Community Patients Families 106

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Eric: Yeah.

Families 83

Families Family IT Illness 83

GeriPal

JANUARY 11, 2024

Panelists Bill Gardner, Sonu Gaind, Leonie Herx have stated they have no relationships to disclose. And so in that context, knowing that there was going to be some evolution of policy in this area, that’s how I got involved consulting with members, trying to understand the situation better, that type of thing.

Illness 144

Illness IT Medical Provider 144

GeriPal

APRIL 13, 2023

I initially got into it because I was really looking at the psychophysiology of stress, and so how stress affects our health and how relationships were always a component of that. But then recognizing that our relationships impact our health even outside the context of stress. .”

IT 98

IT Community Patient-Centered Medical 98

GeriPal

SEPTEMBER 19, 2024

Alex 00:34 We are delighted to welcome back Jennifer Tem e l, who is a thoracic oncologist at Massachusetts General Hospital in Boston. Chris 07:41 Yeah, it’s a really interesting thing, because the 2010 article was solving the problem of, hey, send us patients, we promise we won’t kill them. Jennifer 00:44 Thanks.

Patient-Centered 117

Patient-Centered IT Patients Hospital 117

GeriPal

APRIL 18, 2024

Because I remember there was an article maybe six months ago in JAGS, maybe it was longer than that, everybody was talking about ChatGPT-3.5, And our point, in this article, is that it’s an inherently unsafe system because humans suck at that. Let me ask you a question. And they suck at it for a lot of reasons.

Electronics 139

Electronics IT Patients Healthcare 139

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” Widera and Smith have no relationships to disclose. Josh: Yeah.

Patient-Centered 127

Patient-Centered IT Patients Consulting 127

GeriPal

APRIL 26, 2024

Widera and Smith have no relationships to disclose. Guest Betty Ferrell has no relationships to disclose. Mary Dwyer, who is a lawyer, and bioethicist and assistant professor at Case Western Reserve and University Hospitals. From you reading the 2022 article that was authored? Jenny: Good to be here. Is that right Josh?

Patient-Centered 118

Patient-Centered IT Patients Consulting 118

GeriPal

JULY 25, 2024

Summary Transcript Summary We are dusting off our crystal balls today with three amazing guests who have all recently published an article on prognosis over the last couple months: Kara Bischoff, James Deardorff, and Elizabeth Lilley. Widera and Smith have no relationships to disclose. Alex 00:12 This is Alex Smith. Liz 00:32 Thanks.

Families 105

Families Family Patient-Centered IT 105

GeriPal

NOVEMBER 3, 2022

And I chose one in particular experience to write about, a trans woman who I call Jamie in the piece, who I had known prior to the pandemic who I was treating as a palliative care consultant for her cancer related pain. The primary loss almost always sets into motion a further cascade of social and emotional consequences. She was homeless.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

GeriPal

JULY 17, 2025

The key is that looking inwards to understanding our own unique relationship with mortality can deepen our ability to authentically accompany the experiences of our patients. Articles : Emanuel LL, Solomon S, Chochinov HM, et al. So maybe a hospitalized patient tells you, I have insomnia, doc, I need medication. J Palliat Med.

Patient-Centered 65

Patient-Centered IT Patients Relationship 65

GeriPal

AUGUST 22, 2024

Knowing I was interested in neurology and had opportunities to observe brain death determination in the hospital. I think, Winston, in your article, you even said for probably brief periods of time, they’re still conscious. So in the case of Jahi McMath, you were talking about, you know, her family was kicked out of the hospital.

IT 112

IT Families Family Patient-Centered 112