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.

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Hospital IT Patient-Centered Patients 125

The Motivated MD

SEPTEMBER 19, 2024

For the better half of 2024, I have been periodically writing posts that are individual articles that double as potential chapters to a future book. Before we discuss each individual savings account, let us first highlight exactly what it means to ‘automate’ your savings. So yes, humans make mistakes.

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Finance Education Individual Healthcare Professional 52

GeriPal

APRIL 3, 2025

We discuss our favorite articles, parody songs, and memories from AGS meetings past, with a little preview of a song for this years meeting. We covered: The first parody song I wrote, for AGS 2018 in Orlando , about this article by Nancy Schoenborn on how to discuss stopping cancer screening. And then I got to choose the first article.

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IT Hospital Screening Patients 64

GeriPal

NOVEMBER 2, 2023

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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Board-Certified IT Community Medical Student 91

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.

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Patient-Centered IT Illness Patients 122

GeriPal

OCTOBER 20, 2022

This all came out from JAGS just published their first Clin-STAR corner, which is, and we’ll talk about what that is, but it’s a series of articles bringing in specialists to talk about updates in the last couple years within their field. So this point led us to select these articles. Eric: That’s exciting.

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Complication Patient-Centered IT Patients 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?

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Vaccination IT Individual Healthcare 87

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast.

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Patient-Centered Hospital Patients IT 132

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. But we’re not perfect individuals.

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Primary Care Patient-Centered IT Patients 113

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. 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? Jennifer: Thanks.

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Illness Hospital Patient-Centered Patients 110

GeriPal

NOVEMBER 14, 2024

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. Sarah 11:14 So it’s really assessing patients for their individual risk factors for falls. Vision is another obvious one.

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IT Screening Patient-Centered Community 124

GeriPal

NOVEMBER 7, 2024

-Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. Eric 11:50 I also have to ask, because we will have a link to this article.

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Management Patient-Centered Patients IT 116

GeriPal

MAY 18, 2023

Eric: And in the article that’s being published in JAGS, you have multiple tables. Eric: So I guess it was table two in the JAGS article is about potentially inappropriate drugs. The review articles, the case studies, opinion pieces, things like that. So we’re trying to find articles that maybe support.

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Medical IT Patients Clinic 97

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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay. What is sludge?

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Patient-Centered Hospital IT Illness 116

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.

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Family Families Patient-Centered IT 112

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.

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Patient-Centered Illness Healthcare IT 115

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?” This is Eric Widera.

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Families Family Patient-Centered IT 97

GeriPal

MAY 25, 2023

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. Health care system drives where you end up, which hospital, which state you live in. Your thoughts?

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Community IT Patient-Centered Primary Care 95

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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IT Provider Patients Family 113

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. Within the VA it’s now at 70 VA hospitals. So it’s a very scary culture for people who are not in healthcare. Alex: Yeah.

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IT Patient-Centered Healthcare Illness 105

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. Eric: Which brings us to an article. Jessie: Exactly.

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Illness Patient-Centered Screening IT 136

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. J Am Geriatr Soc. 2022 Perioperative Gabapentin Use in Older AdultsRevisiting Multimodal Pain Management JAMA IM.

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Patient-Centered IT Healthcare Medical 96

GeriPal

FEBRUARY 8, 2024

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

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IT Family Families Physicals 137

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

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Patient-Centered IT Patients Healthcare 109

GeriPal

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. It’s the same measure we used in the New England journal article.

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Telehealth Patient-Centered IT Patients 105

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

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Patient-Centered IT Patients Illness 126

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. Was the clinician working frontline in those community hospitals? hospice use).

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Patient-Centered IT Hospital Patients 77

GeriPal

JUNE 30, 2022

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. Joel: The Brigham and Women’s Hospital likes me to say that too. Did I get that right?

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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.

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Illness IT Patient-Centered Family 136

GeriPal

FEBRUARY 20, 2025

A great Curbsiders podcast episode on Trauma-informed care with Megan Gerber CAPCs Trauma-informed care toolkit Mariahs article on Home-Based Care for LGBTQ or another diverse gender identity Older Adults ** This podcast is not CME eligible. And you can’t really predict how each individual might react to the same experience.

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IT Patient-Centered Screening Patients 66

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.

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IT Patient-Centered Family Families 104

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. Individuals over 65 years of age at home Yes 23 (65.7) 150 (54.3)

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Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

SEPTEMBER 21, 2023

I started going to the literature and I noticed that communities of color, those with the Hispanic background, Black individuals were disproportionately impacted by dementia, and I couldn’t believe it. I think, again, it’s the person’s individual, their preference. Alex: Yeah, I like that approach too.

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Community Family Families IT 128

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.

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Illness IT Patient-Centered Patients 107

GeriPal

AUGUST 24, 2023

Just an extraordinary cast of individuals who were really so incredibly inspiring. And I had no idea what that would look like or what I would do until I happened upon an article by actually a fellow Winnipegger, a man named Jim Brown who was an expert in mood disorders. So tiny, tiny, in a hospital bed.

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Patient-Centered Patients IT Illness 98

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. I always thought this article came out 2011. Transcript. This is Eric Widera.

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Illness Patient-Centered IT Patients 102

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. Eric: Six months ago. Ramona: Glomerular Filtration Raterate. Eric: Yes.

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IT Patient-Centered Healthcare Patients 91