GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 125

IT Patient-Centered Hospital Individual 125

GeriPal

JANUARY 23, 2025

Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes. Patients received brochures detailing the risks of gabapentinoids, nonpharmacologic alternatives, and a proposed deprescribing regimen (see here for the brochure ). in the usual care group.

Specialization 120

Specialization IT Patient-Centered Medical 120

GeriPal

DECEMBER 2, 2022

She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. You wrote about how when it comes to talking about patients with dementia, they’re rarely portrayed as resilient. Eric: In the article, you wrote about creative engagement. When was that, 2010?

Community 102

Community IT Individual Patient-Centered 102

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

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. This is Eric Widera.

Illness 109

Illness IT Patient-Centered Patients 109

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.

Illness 137

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

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 126

Hospital IT Patient-Centered Patients 126

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 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? For more details, please click here. (AP AP Recruit Job No.

Illness 102

Illness Mental Health IT Patient-Centered 102

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. Storytelling Helps Hospital Staff Discover The Person Within The Patient. Integration of Person-Centered Narratives Into the Electronic Health Record: Study Protocol.

Patient-Centered 116

Patient-Centered Illness Healthcare IT 116

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.

Mental Health 123

Mental Health Patient-Centered Illness Screening 123

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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.

Illness 111

Illness Hospital Patient-Centered Patients 111

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

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

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 98

IT Patient-Centered Patients Board-Certified 98

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? Abby: Thank you.

Families 144

Families Family Patient-Centered IT 144

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? She was a heart failure patient. Been in the hospital four times, vented, been told the story to her family, she won’t live.

IT 106

IT Patient-Centered Healthcare Illness 106

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

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. Participants were critically ill and intubated. What is sludge? What to make of that?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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?” That’s a huge amount of news all at once. Lynn: I do.

Family 98

Family Families Patient-Centered IT 98

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

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

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. . AlexSmithMD . Transcript.

Illness 110

Illness IT Families Family 110

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. 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. This is Eric Widera.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. What is making this hard for me? What do they do?

Patients 74

Patients Clinic Patient-Centered Illness 74

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 113

Families Family Patient-Centered IT 113

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? Alex 10:41 No, they don’t.

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

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. And PAIR stands for the Palliative and Advanced Illness Research Center. and consulting for Papa Health.

Consulting 122

Consulting Hospital Patient-Centered IT 122

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.

IT 129

IT Families Family Patient-Centered 129

PEMBlog

MAY 24, 2023

Patient that are agitated should always be treated with dignity and respect. These articles will take another look at the content included in this episode. This entails utilizing the least invasive non-pharmacologic means of assisting them, before moving to physical or chemical restraints.

Management 54

Management Patient-Centered Physicals Finance 54

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. Alex: And the Brigham and Women’s Hospital. Transcript.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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.

Illness 73

Illness IT Healthcare Patient-Centered 73

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

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78