GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. For example, with peritoneal dialysis and conservative management.

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GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. Summary Transcript Summary. Alex: This is Alex Smith. Welcome to the GeriPal podcast, Chrissy.

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GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 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. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004. 2023.11.004.

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GeriPal

OCTOBER 12, 2023

I love this series of articles because each presents a component of a practical, patient-centered approach to patient-surgeon communication and decision making, and language surgeons (and surgical trainees) can start using in their next patient visit. Alexis, welcome to GeriPal. Alexis: Thanks for having me. Alexis: Yeah.

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GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. Eric: Oh, wow.

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GeriPal

MAY 22, 2025

And I was looking for articles, and I wasn’t seeing as many as I expected. Jenny 04:45 Like, the last article was, like, 10 years ago. Eric 11:13 And, Tyler, that’s why I loved your article at J Gym on bringing music and benefits to patients at the bedside. Eric 04:42 There was even less on GeriPal. Can you tell us?

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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. And I would say we weren’t doing training on symptom management, for example.

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GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. We got a couple of articles to discuss and a lot of different components of this.

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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? They want to be able to manage their own symptoms. Eric 39:13 No, there was actually in Colorado, I think there was that Atlantic article or New Yorker.

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GeriPal

JULY 28, 2022

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. 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.

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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 so there’s complexity in Understanding how each state manages this. Because I mean, California is different. They have an advance directive.

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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. Eric: I felt that reading the article. We’ll have a link to that article on our show notes. Ann: Likely.

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GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

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GeriPal

DECEMBER 14, 2023

So we’re going to have a link to the article that you published in JAMA IM titled The Hospital Culture and Intensity of End-of-Life Care at Three Academic Hospitals. And it was amazing just seeing the differences in how end-of-life care is managed at those three institutions, which were all a subway right away from each other.

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GeriPal

AUGUST 11, 2022

In particular, she reminds us that when we think about the most challenging of our patient encounters, they almost always involve a complex psychosocial dynamic, and this has received far less attention than communication and symptom management issues. . There was a Stanford article talking about you as a pioneer in this field.

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GeriPal

MARCH 24, 2023

For a deeper diver into these issues, check out some of the following links: Ira’s Stat new article “Hospice care needs saving” GeriPal’s episode on the growing role of private equity in hospice care Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations. Ira: I like the article. Thank you, Anne.

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GeriPal

FEBRUARY 22, 2024

They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. Because often what we hear from patients, “I do a lot of pain management research,” but mood comes up in that a lot, is that, “Oh, I don’t want to talk to my doctor about this.

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GeriPal

APRIL 14, 2022

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: . Article on buprenorphine in the elderly. Management of chronic pain in the elderly: focus on transdermal buprenorphine.

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GeriPal

JUNE 22, 2023

Michele: Yeah, so in May of 2018, there was an article by Suleika Jaouad in the New York Times Magazine, and they spent about two weeks in our hospice with us learning about the work that’s done. And so the article focuses on the work of these three men who were mostly gang involved and did something really bad when they were young.

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GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live.

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GeriPal

AUGUST 25, 2022

And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices. It’s something we need to pay attention to, which is what we were talking about in the article. AlexSmithMD. Transcript.

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BMJ

MAY 10, 2022

Introductory article to İkİIşik H, Sezerol MA, Taşçı Y, et alCOVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from TurkeyFamily Medicine and Community Health 2022;10:e001430. Statistical significance level was accepted as p<0.05.

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GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live.

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GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. The family dynamics are different though. Abby: Yeah. Andrea: I agree entirely, Eric.

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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? Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? But if we’re going to have a family meeting, that’s a different circumstance.

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Illness IT Patient-Centered Patients 125

GeriPal

FEBRUARY 6, 2025

On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. And then the family tells me they can’t keep an appointment, they can’t manage their finances. Well, there’s my complaint. Alex 26:33 Yeah.

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GeriPal

APRIL 24, 2025

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. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET?

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GeriPal

OCTOBER 17, 2024

I’d also like to give a shout out to a recent ACP article on HFpEF with an outstanding contribution from Ariela Orkaby, geriatrician extraordinaire (we also just did a podcast with her on frailty ). ** This podcast is not CME eligible. A pill organizer, having family. Eric 19:32 And I love this. The quality of life matters more.

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GeriPal

JUNE 15, 2023

For example, there was one article that we reviewed for Jags where it asked great questions, they gave great prompts, and ChatGPT answered great questions about antipsychotics and gave a list of references to back up ChatGPT’s assertions. Our names were slightly off. And they were complete hallucinations. Alex: Go ahead Matt.

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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).

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GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? In today’s podcast we talk with surgeon Samir Shah and Health Services Researcher Joel Weissman about a pair of JAGS articles they published on the outcomes of high risk surgery and advance care planning among persons with dementia. She has advance dementia.

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GeriPal

JUNE 29, 2023

But the other was she read an article about our hospice in the May of 2018 New York Times magazine. And that article really, it’s by Suleika Jaouad, and it focused on some of the peer workers that we have. And she read that article and was very moved by the work that these men are doing, and so she wrote the song about that.

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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 ). John: I am what I am, which is a family practice doctor. That dawned on me.

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GeriPal

MARCH 2, 2023

I could go on and on, but listen to the podcast instead and for a deeper dive, take a look at the following articles and studies: Gabapentin in the Perioperative setting: Prolonged use of newly prescribed gabapentin after surgery. 2022 Perioperative Gabapentin Use in Older AdultsRevisiting Multimodal Pain Management JAMA IM.

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GeriPal

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. A good prescriber, a good symptom control manager.

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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 I tried to get her actually to pain management, and I couldn’t. So basic pain management goals of care conversations.

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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 great article. It’s been a while since we’ve done a Covid/bioethics podcast (see prior ethics podcasts here , here , here , and here ). Eric: Yeah. Eric: Thank you.

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