GeriPal

JUNE 27, 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.

Illness 130

Illness IT Diagnosis Patient-Centered 130

PEMBlog

OCTOBER 2, 2024

I’ll dive into the latest clinical practice guidelines and discuss evidence-based approaches to diagnosis and treatment. Understanding dyspepsia and its clinical presentation. uh, ill defined epigastric or chest pain, and it’s often worse by eating or lying down after meals. Use symptoms as your diagnosis.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

NOVEMBER 21, 2024

Coping in the setting of serious illness. Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. The clinical trials and the this and that. Here are some more resources we’ve discussed in the podcast Dani’s NEJM article on coping: “ Should I Laugh at That? Should I laugh at that?

Illness 126

Illness IT Patient-Centered Patients 126

GeriPal

JUNE 12, 2025

During my training, I didn’t receive much education about radiation oncology, and I’m not entirely sure what some of the terms mean (hypofractionated means fewer sessions, right?). I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. So I think education is key.

Patient-Centered 103

Patient-Centered Referral Patients IT 103

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? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 102

Illness Mental Health IT Patient-Centered 102

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

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. When people have no appetite, they know they’re ill. Eduardo 10:42 Sure, Eric.

Illness 134

Illness Patient-Centered Patients IT 134

GeriPal

MARCH 9, 2023

FDA is considering approval, shifting away from Schedule I restrictions, paving the way for use in clinical practice. 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). Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

JULY 11, 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.

Patient-Centered 110

Patient-Centered IT Patients Clinic 110

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Holly, welcome to GeriPal. Holly 01:23 Thank you.

IT 133

IT Illness Families Family 133

GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. But rarely does the podcast and clinical reality meet in the same day. Ann Henshaw is an occupational therapist who works clinically at Georgetown and teaches at GW. Alex: Today we are delighted to welcome Ann Henshaw who brought this podcast idea to us.

Patient-Centered 133

Patient-Centered Hospital Patients IT 133

GeriPal

OCTOBER 20, 2022

And they should be forced by doing research, followed by translating research into practice and continued education of a wide variety of individuals to then care for our aging population. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

AUGUST 11, 2022

– Serious Illness Conversation Guide podcast. What I fell in love with and felt incredibly compelled by was the taking care of seriously ill patients and particularly helping them negotiate emotionally the experience of being very seriously ill. AlexSmithMD . Links: – PDIA Faculty Scholars Program. Transcript.

Illness 110

Illness IT Families Family 110

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is a clinical intervention.

Family 98

Family Families Patient-Centered IT 98

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. Areej: So when I was in college, I had a close friend who had a serious illness and actually died as a result of cancer. I entered medical school and I did a course that was offered that’s called living with a life threatening illness.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness.

Medical 100

Medical IT Patient-Centered Healthcare 100

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

SEPTEMBER 28, 2023

A “Three-Stage Protocol” for Serious Illness Conversations: Reframing Communication in Real Time Transcript Eric: Welcome to the GeriPal podcast. And any examples from your own clinical experiences of miscommunication? Patient Values: Three Important Questions-Tell me more? What else? This is Eric Widera. Eric: Yeah.

Families 144

Families Family Patient-Centered IT 144

GeriPal

NOVEMBER 7, 2024

We also briefly mention Susan Wong’s terrific studies that found a disconnect between older adults with renal failure’s expressed values, focused on comfort, and their advance care planning and end-of-life care received, which focused on life extension; and another study that found quality of life was sustained until late in the illness course.

Management 117

Management Patient-Centered Patients IT 117

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. AMA PRA Category 1 credit(s) ™.

Illness 144

Illness IT Medical Provider 144

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

JULY 21, 2022

Love to talk about also in the serious illness population. I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would.

IT 102

IT Families Family Diagnosis 102

GeriPal

MARCH 28, 2024

Ten years ago we would have been hard pressed to find 3 clinical trial abstracts submitted to the annual meeting, much less high quality randomized trials with robust measures, sample sizes, and analytics plans. Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. Eric: Okay.

Consulting 116

Consulting Patient-Centered IT Patients 116

GeriPal

OCTOBER 12, 2023

And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications? Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis?

IT 129

IT Families Family Patient-Centered 129

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. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center. What is sludge?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

GeriPal

NOVEMBER 17, 2022

The songs about how saving lives is actually a pretty complicated business. And when I was getting my PhD, I wanted to find something that spoke to me, and I had been doing clinical work in nursing homes. And that’s the complication here is there’s so many things that the staff can be trained on. Alex: Yeah.

Community 97

Community IT Mental Health Medical 97

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Relationships are usually more complicated. Eric 34:49 And Jenny, how are you planning to involve music once you’re done with fellowship in your clinical work? There are lots of people involved. That was beautiful.

IT 98

IT Patient-Centered Patients Board-Certified 98

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. She softened to her suffering, and she trusted me enough to have a moment, that she could look into that and see that, yes, she had her clinical judgment, which was fine, but also that there was another processes going on, which was her own suffering. Pain Manag Nurs.

IT 137

IT Families Family Physicals 137

GeriPal

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. I can name probably 10 organizations across the United States where you can get education on being an end-of-life doula and they’re all slightly different.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

FEBRUARY 13, 2025

And so we worked closely with a community advisory group who, through focus groups, told us how it was that black and white individuals with serious illness had wanted to be treated. They wanted you to be respectful of their cultural beliefs and their, you know, faith beliefs that were driving their health and illness. Marie 11:03 Yes.

Consulting 64

Consulting Community Patient-Centered Families 64

GeriPal

JUNE 6, 2024

Sharon Bober, clinical psychologist at DFCI, notes that clinicians can get caught in an anxiety cycle, in which they are afraid to ask, don’t ask, then have increased anxiety about not asking. Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. Clearly this issue is important to patients.

Illness 131

Illness IT Physicals Patients 131

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. We did it by the clinic level. I’ve had fun relearning Spanish.

Primary Care 80

Primary Care IT Clinic Illness 80

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MAY 1, 2025

Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. Older adults may not have received AIDS education. Millions of lives are at stake.

Primary Care 96

Primary Care IT Clinic Provider 96

GeriPal

SEPTEMBER 14, 2023

If you are interested in learning more and meeting a community of folks interested in hospital-at-home, check out the hospital-at-home user group at hahusersgroup.org or some of these publications: Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. Annals of Int Med. Bruce: Sure.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

PEMBlog

DECEMBER 4, 2024

We will review the clinical presentation, diagnostic strategies, management protocols, infection control practices, and vaccination updates. Learning Objectives Understand the clinical progression of pertussis through its three distinct stages and identify key symptoms, including age-specific presentations in infants and older children.

IT 52

IT Vaccination Diagnosis Complication 52

GeriPal

JULY 16, 2024

And if we’re seeing somebody in the clinic, how they might be able to do things in four years, we’re looking ahead to try to slow any progression down. If you are concerned that your silence can be a form of complicity and bad behavior, too, we have a certain amount of expertise. Ken 05:40 That’s right.

Diagnosis 141

Diagnosis Diagnose IT Physicals 141