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.

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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.

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Patient-Centered IT Illness Patients 123

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.

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Telehealth Patient-Centered IT Patients 106

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.

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Illness IT Patient-Centered Families 136

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. A few data based publication links from Person-Centered Narrative Intervention Program of Research: .

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Patient-Centered Illness Healthcare IT 116

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.

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IT Patient-Centered Patients Board-Certified 98

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. 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.

Illness 111

Illness Hospital Patient-Centered Patients 111

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 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. Rather, most of us live and make decisions in relationship to one another.

Families 98

Families Family Patient-Centered IT 98

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. Panelists BJ Miller and Naomi Saks have no relationships to disclose. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study.

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IT Families Family Physicals 137

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. But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No Alex: It’s a great choice.

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IT Patient-Centered Healthcare Illness 106

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

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.

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IT Patient-Centered Patients Healthcare 100

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. – Serious Illness Conversation Guide podcast. There was a Stanford article talking about you as a pioneer in this field. AlexSmithMD .

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Illness IT Families Family 110

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?

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Patients Clinic Patient-Centered Illness 74

GeriPal

FEBRUARY 29, 2024

Widera and Smith have no relationships to disclose. Guest hosts Lynn Flint and Anne Kelly have no relationships to disclose. The ones who are publishing interesting articles are easy as we knew MAID is always going to be a controversial topic. AMA PRA Category 1 credit(s) ™. ” Very specific, rare circumstance.

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IT Patient-Centered Illness Education 127

GeriPal

APRIL 4, 2024

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. Widera and Smith have no relationships to disclose. Guest Laurie Dornbrand has no relationships to disclose.

Families 113

Families Family Patient-Centered IT 113

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Ivermectin to treat cancer. Stem cell treatments.

Patient-Centered 79

Patient-Centered IT Patients Illness 79

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 ). He looked very ill. My wife is also a physician and she said he’s dying.

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Provider Illness IT Healthcare 119

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades.

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Illness IT Medical Provider 144

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. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 126

Hospital IT Patient-Centered Patients 126

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. Panelists Kate Courtright and Scott Halpern have no relationships to disclose. And PAIR stands for the Palliative and Advanced Illness Research Center.

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Consulting Hospital Patient-Centered IT 122

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. I loved the relationship that we developed and the fun we had.

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IT Patient-Centered Families Family 105

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

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. And then there are a number of groups that go out in vans and cars and go out into the surrounding community of Kerala to provide care for patients who are in their homes. What do you think about that?

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Community IT Relationship Healthcare 116

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? I’m Marie Bakitas, and I’m a professor at the University of Alabama at Birmingham and also the associate Director of the center for Palliative and Supportive Care.

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Consulting Community Patient-Centered Families 64

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. But, should we as clinicians care about the social lives of our patients?

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IT Community Patient-Centered Medical 100

GeriPal

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. Ashwin 00:49 Excited to be back. Kate, do you have the song request?

Patient-Centered 67

Patient-Centered IT Individual Screening 67

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. ” And you start entering into a conversation about support or relationships and things of that nature.

IT 99

IT Patient-Centered Families Family 99

GeriPal

MARCH 20, 2025

Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self?

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IT Patient-Centered Patients Medical 89

GeriPal

SEPTEMBER 5, 2024

And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics. And he’s also chaired the California Pacific Medical Center’s ethics committee since 1985.

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Patients IT Patient-Centered Hospital 98

GeriPal

SEPTEMBER 8, 2022

Alex: We are so fortunate to be joined by one of my former mentors who I’ve known for 20 years, Holly Prigerson, who is now Irving Sherwood Wright Professor of Geriatrics at Weill Cornell Medical School and Professor of Sociology and Medicine and Director of the Center for Research on End Of Life Care. Holly: In advance.

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IT Complication Relationship Specialization 100

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” Widera and Smith have no relationships to disclose.

Patient-Centered 129

Patient-Centered IT Patients Consulting 129

GeriPal

APRIL 26, 2024

Summary Transcript Summary As Betty Ferrell says on our podcast today, nurses play an essential role in care of people with serious illness. Who spends the most time with the patient in the infusion center? Widera and Smith have no relationships to disclose. Guest Betty Ferrell has no relationships to disclose.

Patient-Centered 121

Patient-Centered IT Patients Consulting 121

GeriPal

JULY 25, 2024

Summary Transcript Summary We are dusting off our crystal balls today with three amazing guests who have all recently published an article on prognosis over the last couple months: Kara Bischoff, James Deardorff, and Elizabeth Lilley. Widera and Smith have no relationships to disclose. Why do this? AMA PRA Category 1 credit(s) ™.

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Families Family Patient-Centered Patients 108