GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. 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.

Management 117

Management Patient-Centered Patients IT 117

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. VA “gets” the importance of storytelling in medicine, without the need for reams of research to back it up. Journal of Palliative Medicine , 23 (6), [link]. Bennett, C.R.,

Patient-Centered 116

Patient-Centered Illness Healthcare IT 116

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 110

Patient-Centered IT Patients Healthcare 110

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. When I see a patient? Matthew, I get the lyrics.

Primary Care 114

Primary Care Patient-Centered IT Patients 114

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.

IT 106

IT Patient-Centered Healthcare Illness 106

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. . Susan: Thank you.

Illness 110

Illness IT Families Family 110

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Inspired by Dani Chammass paper in Annals of Internal Medicine titled, Wishing for a no show we talk about countertransference: start by asking yourself, Why am I having difficulty? Who follows the patient once the cancer goes into remission?

Patients 74

Patients Clinic Patient-Centered Illness 74

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. This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. What is sludge? Where was it?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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

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. So I identified myself, and was working in our local cancer center.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. Think vitamins.

Patient-Centered 79

Patient-Centered IT Patients Illness 79

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? This is not why I went into emergency medicine. I went into emergency medicine to act. I went into emergency medicine to act.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

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?

IT 67

IT Patient-Centered Individual Screening 67

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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.

Consulting 64

Consulting Community Patient-Centered Families 64

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?

IT 89

IT Patient-Centered Patients Medical 89

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.

Families 94

Families Family IT Patient-Centered 94

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.” From you reading the 2022 article that was authored?

Patient-Centered 129

Patient-Centered IT Patients Consulting 129

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. Eric 00:13 And Alex, we have a super special today, three different articles. Why do this?

Families 108

Families Family Patient-Centered Patients 108

GeriPal

APRIL 26, 2024

Who spends the most time with the patient in the infusion center? And we’re delighted to welcome Jenny back to the GeriPal podcast, Jenny Blumenthal-Barby, who’s a philosopher and bioethicist and associate director for the Center for Medical Ethics and Health policy at the Baylor College of Medicine.

Patient-Centered 121

Patient-Centered IT Patients Consulting 121

GeriPal

JULY 6, 2023

It could be in housing, it could be a standalone senior center, home delivered meals, nutrition counseling and nutrition education done by registered dieticians. I would hope a referral would go to what’s called an ADRC, and it’s called an Aging and Disability Resource Center. I think most states have them.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

MARCH 27, 2025

Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a pragmatic trial of advance care planning (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying commentary in JAMA Internal Medicine. I’m hearing dementia patients or patients with dementia.

Primary Care 80

Primary Care IT Clinic Patient-Centered 80

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. Institute for Poetic Medicine. 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).

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

AUGUST 15, 2024

Lingsheng (and I) recently published studies on this in JAMA Internal Medicine , and JAGS. Ongoing reports from patients about anti-Asian hate experiences Should clinicians screen for Anti-Asian hate? See also guides for how to confront and discuss anti-Asian hate in these articles in the NEJM and JGIM.

Mental Health 118

Mental Health Community Screening IT 118

GeriPal

FEBRUARY 2, 2023

I had heard of course heard of imposter syndrome in the past but I didn’t make the connection to myself until I read this article and saw my thoughts printed on the page. Even declining to review an article for a journal is accompanied by some stomach knots (it’s so hard to find reviewers!) And it was a wonderful talk on mentoring.

IT 105

IT Medical Student Medical Families 105

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 126

Patient-Centered IT Families Family 126