GeriPal

JANUARY 23, 2025

Summary Transcript CME Summary Its another deprescribing super special on today’s GeriPal Podcast, where we delve into the latest research on deprescribing medications prescribed to older adults. Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes.

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Specialization IT Patient-Centered Medical 119

GeriPal

MAY 5, 2022

If you want to take a deeper dive into this subject and read some of the articles we discussed in the podcast, check out the following: Hearing Loss: Effect on Hospice and Palliative Care Through the Eyes of Practitioners. Including more hospital utilization or healthcare utilization, maybe cognitive impairment issues. Transcript.

IT 102

IT Screening Hospital Clinic 102

GeriPal

DECEMBER 2, 2022

We discuss the importance of viewing individuals with dementia from a lens of resilience, the importance of creative engagement ( as noted in Anne and Susan’s wonderful article on this subject) , the role of collaborative care, and what we can do to improve inclusivity for individuals with dementia in our community and health care systems.

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Community IT Individual Patient-Centered 101

Pamela Wible MD

JUNE 20, 2025

(Published 3/18/19, updated 6/20/25) What Is Physician “Burnout”—and Why It Matters Physician “burnout” is a state of emotional, physical, and mental exhaustion caused by prolonged stress in the medical workplace. and it has been linked to rising rates of physician depression , doctor suicide , and medical errors.

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Medical Student Diagnosis Physicals Medical 246

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. What are the risks and rewards of new classes of medications? When I’m on nursing home call, the most common page I receive is for a blood sugar value. How high is too high?

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Diabetes Management Patient-Centered Family 73

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. We’re doing a lot of interactive relationship building. When somebody is not able to function, they need deep therapy, and probably maybe even hospitalization.

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Board-Certified IT Primary Care Referral 110

GeriPal

MAY 18, 2023

Summary Transcript Summary Hot off the press is a brand spanking new updated 2023 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The Beers Criteria is one of the most frequently cited reference tools in geriatrics, detailing potentially inappropriate medications to prescribe to older people.

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Medical IT Patients Clinic 97

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. And so for me, I started off at one particular institution for medical school and went to another and noticed quite a few differences.

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Hospital IT Patient-Centered Patients 125

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.

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Patient-Centered Illness IT Patients 122

GeriPal

MAY 22, 2025

You can hear Tyler and I having a great time singing together and sharing stories around his podcast My Medical Mixtape. And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ? And so this is a shout out to our inpatient palliative team at Dell Medical School.

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IT Patient-Centered Patients Board-Certified 96

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. Summary Transcript CME Summary It is a battle royale on this weeks GeriPal podcast. But watch out!

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Telehealth Patient-Centered IT Patients 105

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?” Eric: Lynn or Anne?

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Family Families Patient-Centered IT 97

GeriPal

OCTOBER 17, 2024

Summary Transcript CME Summary When treating heart failure, how do we distinguish between the expanding list of medications recommended for “Guideline Directed Medical Therapy” (GDMT) and what might be considered runaway polypharmacy? He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge.

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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.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

NOVEMBER 7, 2024

And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management. Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Panelists BJ Miller and Naomi Saks have no relationships to disclose. 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. 2023.11.004.

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IT Family Families Physicals 137

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

FEBRUARY 22, 2024

Widera and Smith have no relationships to disclose. Panelists Elissa Kozlov and Desiree Azizoddin have no relationships to disclose. And then also this stoicism or fear of detracting the provider’s attention from their medical symptoms that they want their doctor to stay focused on too. Alex: This is fascinating.

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Mental Health Patient-Centered Illness Screening 122

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. We’re going to be talking about the American Geriatric Society position statement on making medical treatment decisions.

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Patient-Centered IT Patients Healthcare 109

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. Panelists Kate Courtright and Scott Halpern have no relationships to disclose. and consulting for Papa Health.

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Consulting Hospital Patient-Centered IT 120

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. . Brian: Thanks so much.

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Illness IT Family Families 109

GeriPal

MAY 12, 2022

He is also author of the book, “ Walk with the Weary: Lessons in Humanity in Health Care ,” and was featured in this Atlantic article. Raj: It was indeed very, very gradual, and the seeds were sown when I was a medical student. Raj: That’s one of the high tech medical absurdities that we have developed.

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Community IT Relationship Healthcare 115

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

SEPTEMBER 7, 2023

He had a very aggressive lymphoma, highly aggressive, with a lot of different medical conditions. I slowly introduced higher doses as he recovered from his medical conditions that were acute. Eric: 80% that, I work with a lot of cancer patients, sometimes they have a lot of hope, maybe not a lot of trust in the medical system.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

FEBRUARY 27, 2025

Alex 00:27 And we’re delighted to welcome S a ch Kale, who is a palliative care doc at the Ohio State University Wexner Medical Center. But my medical training kicked in. I see this in the hospital when I’m doing addiction medicine consults. But that was my take home from Danny’s article.

Patients 72

Patients Clinic Patient-Centered Illness 72

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. But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No She was a heart failure patient.

IT 105

IT Patient-Centered Healthcare Illness 105

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? You’re a disgruntled medical student. You’re thinking about dropping out of medical school.

IT 104

IT Patient-Centered Family Families 104

GeriPal

APRIL 28, 2022

Nathan: I have drawn for my entire life, but I gave up cartoons because I thought I had to during medical school and residency. But if you look at my lecture notes from medical school, it’s just plastered with cartoons and doodles. I thought doctors are serious, cartoons are not serious. It was in there just trying to escape.

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IT Hospital Patients Illness 145

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. So medication adjustments. Im b leary eyed.

Illness 107

Illness IT Patient-Centered Patients 107

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. hospice use). Tammie 02:56 It usually doesn’t work no matter what. Corita 04:32 Yep.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

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? Alex 00:26 And we’re delayed to welcome Amanda Moment, who is a palliative care social worker at the Brigham and Women’s Hospital in Boston. It’s not in the capacities of what we can do medically.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

JANUARY 18, 2024

Lastly, we discuss Katie’s paper on substance use disorder in an aging population and how one can incorporate the 5 Ms (ie, matters most, medications, mind, mobility, and multicomplexity) into a framework for age-friendly care for older adults with substance use disorder. Eric: Which brings us to an article. Jessie: Exactly.

Illness 136

Illness Patient-Centered Screening Clinic 136

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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Finance Board-Certified IT Provider 95

GeriPal

AUGUST 31, 2023

We have a wide ranging conversation that touches on how to place aging, disability, and multimorbidity in the context of serious illness conversations, “striving toward normal,” stoicism, existentialism, psychedelics, the goals of medicine, medical aid in dying and more. We could have talked for hours! Bill: Thank you. Juliet: Lund, yeah.

Illness 128

Illness IT Diagnose Medical 128

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.

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

APRIL 24, 2025

We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Jill 04:13 So actually we prefer just integrative medicine now because we’re trying to really combine things into one medical system. Why did you even decide to write this article?

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Patient-Centered IT Patients Illness 77