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

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . Transcript.

Illness 103

Illness Patient-Centered IT Patients 103

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. Who do we have with us today? Devon, welcome to GeriPal.

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Illness Patient-Centered Screening Clinic 137

GeriPal

NOVEMBER 21, 2024

We are going to tackle this question and so many more about coping on this week’s podcast with Dani Chammas , a recurring GeriPal guest, psychiatrist, and palliative care doc at UCSF, and Amanda Moment , a Palliative Care Social Worker at Brigham and Women’s Cancer Center. Coping in the setting of serious illness.

Illness 126

Illness IT Patient-Centered Patients 126

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

SEPTEMBER 28, 2023

First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Patient Values: Three Important Questions-Tell me more? Simple, right? Not so much, as each one of these steps is fraught with miscommunication. What else?

Families 144

Families Family Patient-Centered IT 144

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. This week we dive into the challenges with communication when it comes to life sustaining treatments and CPR. This is Eric Widera. Alex: This is Alex Smith.

Illness 136

Illness IT Patient-Centered Families 136

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. Our loves, our triumphs, our failures, our work, our families. . Storytelling Helps Hospital Staff Discover The Person Within The Patient. What’s in a story? Bennett, C.R.,

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Patient-Centered Illness Healthcare IT 116

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

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Illness Mental Health IT Patient-Centered 102

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. But watch out! Travel time can leave this champ vulnerable to fatigue and no-shows.

Telehealth 106

Telehealth Patient-Centered IT Patients 106

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?” Anne Kelly: Hi there. Nice to be here. Lynn: I do.

Families 98

Families Family Patient-Centered IT 98

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

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I was looking for articles, and I wasn’t seeing as many as I expected. Come join us.

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IT Patient-Centered Patients Board-Certified 98

GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? We’ve talked at length on prior podcasts about the failures of aducnumab, Biogen, and the FDA’s decision to approve it. . Heather: Sure.

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IT Patient-Centered Healthcare Illness 106

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. This is my early father’s day gift from the family. And I just want to highlight, Jennifer has a great JPSM article that just came out. Would you also just mind mentioning kind of the JPSM article too? Transcript. This is Eric Widera.

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Illness Hospital Patient-Centered Patients 111

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me.

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Mental Health Patient-Centered Illness Screening 123

GeriPal

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. We had tried to actually select people who didn’t have a serious illness. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

GeriPal

APRIL 4, 2024

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. You write about this, you’ve written this New England Journal article, you’ve written past articles.

Families 113

Families Family Patient-Centered IT 113

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 133

Patient-Centered Hospital Patients IT 133

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. – Serious Illness Conversation Guide podcast. There was a Stanford article talking about you as a pioneer in this field. AlexSmithMD .

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Illness IT Families Family 110

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. Alex: I wonder when we talk about it, because we’ll have links to both Eric Cassell’s argument, and we mentioned another article from Tate.

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IT Families Family Physicals 137

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. Alexis, welcome to GeriPal. Alexis: Thanks for having me. Alexis: Yeah.

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IT Families Family Patient-Centered 129

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. Assigning a surrogate decision maker is important for everyone, including those who don’t have serious illness. Where does POLST fit in with this debate? This is Eric Widera.

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Illness IT Healthcare Patient-Centered 73

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. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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 117

Management Patient-Centered Patients IT 117

GeriPal

JUNE 15, 2023

Alex: And we have Matt DeCamp, who’s joining from the University of Colorado, where he is a primary care internist and bioethicist at the Center for Bioethics and Humanities. My worry though with that is that are we going to be expected to be more productive then, to see more patients? Welcome to the GeriPal podcast, Charlotta.

IT 100

IT Patient-Centered Patients Healthcare 100

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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 127

Patient-Centered IT Patients Illness 127

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. Daneila Lamas wrote about this issue in the New York Times this week -after we recorded – in her story, a family requested an herbal infusion for their dying mother via feeding tube.

Patient-Centered 79

Patient-Centered IT Patients Illness 79

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.

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Hospital IT Patient-Centered Patients 126

GeriPal

FEBRUARY 29, 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.

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IT Patient-Centered Illness Education 127

GeriPal

OCTOBER 24, 2024

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. Eloise, welcome to the GeriPal podcast.

Medical 100

Medical IT Patient-Centered Healthcare 100

GeriPal

MAY 25, 2023

Others cited the call from communities to meet them where they are – be they senior centers, Black-owned businesses, or churches (we have a podcast planned in the fall with Fayron Epps and Karen Moss on the church setting). And as you know, it’s a great article. Welcome to the GeriPal podcast. Hillary: So great to be here.

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Community IT Patient-Centered Primary Care 96

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. So I identified myself, and was working in our local cancer center.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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 ). He looked very ill. My wife is also a physician and she said he’s dying.

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Provider Illness IT Healthcare 119

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades. Alex: Thank you.

Illness 144

Illness IT Medical Provider 144