GeriPal

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. William: Thanks so much.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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? Big randomized control study that came out. Lyndsay: Yes.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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.

IT 96

IT Patient-Centered Patients Board-Certified 96

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. Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). That rings true to me.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

FEBRUARY 6, 2025

How should we screen for cognitive impairment? Who do you think we should be screening and how should we be screening them for these symptoms? Well, so I guess it depends on what you say screening. That screening influences kind of further treatment, actually, probably more importantly, patient outcomes.

Primary Care 95

Primary Care Diagnosis Screening IT 95

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.

IT 137

IT Families Family Physicals 137

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

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 17, 2022

I tell this story because these issues don’t typically register as more than a nuisance for clinicians, who frequently don’t understand why their older patient with osteoporosis is not taking a bisphosphonate. But our patients are walking with their feet, and adherence to bisphosphonates for osteoporosis is poor and decreases with time.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. Gordon Alwasa.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. I had it on my screen. 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. We’re here to talk about palliative care oncology.

Illness 110

Illness Hospital Patient-Centered Patients 110

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 I actually got started in cancer screening also, thanks to some mutual colleagues.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. To learn more about CME for other GeriPal episodes, click here.

IT 66

IT Patient-Centered Individual Screening 66

GeriPal

APRIL 28, 2022

Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. I’m going to share my screen and we can talk about that. And I’m just going to explain it to our listeners, what I’m seeing on my screen. Welcome to the GeriPal podcast, Nathan.

IT 145

IT Hospital Patients Illness 145

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. And decided, interesting article, but it raised as many questions as it answered.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. I think this is a really difficult topic to talk about with patients. She has a point. Prognosis is inherently uncertain. James: Yeah.

IT 95

IT Clinic Screening Patients 95

GeriPal

FEBRUARY 2, 2024

First, in our editorial, we expressed concern about the length of stay metric not being patient centric, though important for health systems focused on cost savings. And, of course, this is what families of patients undergoing palliative care go through. This is 24,000 encounters, over 15,000 patients, 11 hospitals, eight states.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

APRIL 13, 2023

But, should we as clinicians care about the social lives of our patients? Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? Has kept me interested, the patient experience and the older adults in the community, their experience.

IT 99

IT Community Patient-Centered Medical 99

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. So we do have like palliative care through home health agencies that will come in and see patients. Alex 03:21 Beautiful, beautiful song.

Referral 78

Referral Nurse Practitioner Consulting Board-Certified 78

GeriPal

APRIL 6, 2023

Today we have a star-studded lineup, including Lexy Torke of Indiana University, who discusses her RCT of a chaplaincy intervention for surrogates of patients in the ICU , published in JPSM and plenary presentation at AAHPM/HPNA. It is a screening? These studies are important. I guess FICA is not as cool as SKY. Is it an assessment?

IT 99

IT Patient-Centered Families Family 99

GeriPal

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. – @AlexSmithMD Here’s a link to an article about the Palliative Story Exchange. ** This podcast is not CME eligible. And we had these amazing stories.

IT 107

IT Community Patients Families 107

GeriPal

FEBRUARY 13, 2025

How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? We’re gonna be talking about three different articles that are gonna be presented Saturday, I believe, at the annual meeting. Three different articles. I’m Na Ouyang.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MAY 29, 2025

Particularly patients, families. Eric 05:30 And Andrew, I remember when I was a med student, I had a patient with a diffuse brain injury in the ICU on a ventilator. People are patients, families are wondering if their loved one is still in there. You know, I’ve been trying to think of metaphors for thinking about this.

Family 93

Family Families IT Patient-Centered 93

GeriPal

SEPTEMBER 8, 2022

And I got from your article, while the peaks follow this pattern, people feel a lot of different things where it just reminds me of the times I’ve grieved. The post Prolonged Grief Disorder: Holly Prigerson appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional. Or do we have any?

IT 100

IT Relationship Specialization Complication 100

GeriPal

MARCH 10, 2022

And to keep it short work for an article. Ruth: Very strong odor, devoid of furniture, broken screens … Eric: So it was the physical environment and … Ruth: Physical environment. Nursing homes are subsidized by their Medicare, by their rehab patients. Ruth: Mm-hmm (affirmative). Eric: Yeah. That doesn’t work.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

APRIL 18, 2024

We discuss, among other things: Findings that in several studies AI was rated by patients as more empathetic than human clinicians (not less, that isn’t a typo). And I’d say, particularly in healthcare, where we’re not very good. The experience of both patients and clinicians isn’t very good.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

DECEMBER 7, 2023

And on that, I found a link to this article by Rick Moody called Elders in Climate Change, No Excuses, in which he argues that elders are the group that benefited most from the massive consumption of fossil fuels in the post World War II eras. Ruth, you’re involved in including it in the nursing curriculum. They can save a lot of money.

Healthcare 129

Healthcare IT Education Community 129

GeriPal

AUGUST 15, 2024

Ongoing reports from patients about anti-Asian hate experiences Should clinicians screen for Anti-Asian hate? question used to screen for domestic violence. See also guides for how to confront and discuss anti-Asian hate in these articles in the NEJM and JGIM. Add to this, “do you feel safe outside the home?”

Mental Health 116

Mental Health Community IT Screening 116

GeriPal

JULY 13, 2023

On that podcast he and collaborators tested a combined patient and clinician facing communication priming intervention to promote goals of care conversations. We’ll have a link to the article on our notes. But I also want to acknowledge that the senior author of this article was Randy Curtis. Erin: Yeah, I can go first.

Patient-Centered 83

Patient-Centered IT Patients Hospital 83

GeriPal

MAY 1, 2025

And so the patients who had been admitted there to die, essentially most, if not all, got better and HIV became much more of a chronic condition. A review article, which I still like to go to. It is kind of weird that my first publication was in jama, part of the Care of the Aging Patient series. Meredith 11:29 Yeah.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

FEBRUARY 24, 2022

It’s not a new debate but has gathered steam at least in palliative care circles since Sean Morrisons published a JPM article titled “ Advance Directives/Care Planning: Clear, Simple, and Wrong.” We see our patients and our families throughout the illness trajectory into the hospital. Eric: Well, how about just with the debate?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Look also for a forthcoming article by Mike and Redwing in Journal of Pain and Symptom Management on poetry as a healing modality, to be published mid May (will add link when out). Institute for Poetic Medicine.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. It was in the mid-nineties, and about half of the patients that we cared for in the inpatient service were homeless.

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

DECEMBER 1, 2023

In particular we spend a good deal of time talking about what this means for asymptomatic patients who may have an abnormal biomarker, which by the proposed new definition would mean they would now have Alzheimer’s disease. You can’t just give that value to a patient. Eric: Wonderful. laughter] Heather: Good point.

IT 115

IT Clinic Illness Hypertension 115

GeriPal

DECEMBER 21, 2023

Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.” Care Ecosystem.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

JANUARY 5, 2023

We start by talking with Robert Brody, an internist who recalls physicians helping patients die during the height of the AIDS epidemic in San Francisco. Robert was first asked by one of his own patients for assistance in dying in 1991, far before aid in dying was legalized in California in 2016. Lisa Harris piece mentioned on podcast.

Provider 19

Provider Medical Hospital Patient-Centered 19

GeriPal

JULY 14, 2022

Two-thirds of the patients in the home now have COVID-19. Seventeen of your patients are dead. The other physicians who previously saw patients in the nursing home are no longer coming to your facility because you have COVID positive patients. You’re short on gowns and facemasks. Did I summarize that right, Darrell?

Nurse Practitioner 136

Nurse Practitioner Patient-Centered Vaccination Emergency Room 136