GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. Should you stop at “no?” Anne Kelly: Hi there. Nice to be here. Eric: Lynn or Anne?

Family 97

Family Families Patient-Centered IT 97

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Katie, welcome back to GeriPal. Jessie: Yes. And then, looking at- Eric: Wow. So, one out of 10?

Illness 136

Illness Patient-Centered Screening IT 136

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. So delivering those month visits in clinic, often in tandem with their other oncology appointments.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JUNE 27, 2024

If you look in the diagnostical statistical manual, right, the sort of handbook for diagnoses, most of the diagnostic criteria are in some important ways kind of arbitrary, right? The question I would ask is, how helpful is that in our clinical practice? I think when we start to think about where are we encountering pathology, right?

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? So let’s just say you have a healthy 55 year old or 65 year old in your clinic.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

APRIL 4, 2024

She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades.

Family 112

Family Families Patient-Centered IT 112

GeriPal

JUNE 9, 2022

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . We can’t possibly meet the needs of all people with newly diagnosed serious illness. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. Kate: Sure.

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. 50 to 70% of people who are diagnosed with UTIs probably don’t have a UTI. Scott: Yeah.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

OCTOBER 17, 2024

He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge. Alex 04:07 A heart failure clinic playing in the background. Is your impression that HFpEFde is under diagnosed in older adults? Yes, over diagnosed in older adults are about right. Parag 13:23 So I think I would say under diagnosed.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 15, 2023

Alex: And joining us via Zoom, we have Charlotta Lindvall, who is a palliative care physician researcher who studies the intersection of natural language processing and communication data at Dana Farber Cancer Institute, where she also works in clinical informatics. Welcome to the GeriPal podcast, Charlotta. Charlotta: Thank you.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

AUGUST 17, 2023

Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. That was an FDA decision.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

APRIL 14, 2022

This is both a research and a clinical interest of yours. But that just didn’t really resonate with what I saw clinically which was that there was lots of suffering both in the patient, their family and on the clinical team and just felt it was really this space where I didn’t have a lot of evidence to guide me.

Illness 102

Illness Patient-Centered IT Patients 102

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. I moved to Baltimore in 2015 and did clinical fellowship in geriatrics.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

SEPTEMBER 22, 2022

And in response, the family or patient looked at you like you were from another planet? Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. Links: – Uncanny Valley post on Josh’s fantastic substack Notes from a Family Meeting. Eric: So yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

SEPTEMBER 21, 2023

Fayron: I think I was interested in family caregiving early on because I had it in my family, but it wasn’t until my postdoc days when I was writing my application that I needed to narrow it down. Those are the things that Black family caregivers that I’ve been working with go through.

Community 128

Community Family Families IT 128

GeriPal

FEBRUARY 16, 2023

Alex: And we’re delighted to welcome back to the GeriPal podcast, Keri Brenner, who is also a psychiatrist and palliative care doctor and clinical associate professor at Stanford. I’m really excited about this because clinically this happened to me, somebody was very angry at something we were talking about.

Patients 109

Patients IT Family Families 109

GeriPal

AUGUST 25, 2022

And yet, we know little about the clinical experience of people with dementia in hospice. And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices. AlexSmithMD. Transcript. Melissa: Sure.

Family 106

Family Families IT Patients 106

GeriPal

FEBRUARY 22, 2024

Is it that they’re clinically depressed or that they’re understandably sad at the situation that they’re in or specific issues? They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. It’s high, it’s too high. Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

MAY 9, 2024

Alex: And Sammy Winemaker, who’s a palliative care physician and Associate Clinical Professor at McMaster University in the Department of Family Medicine, Division of Palliative Care. It’s just normal kind of talking to people because you are scuppered if you can’t connect with the patients and families in their home.

Education 127

Education IT Illness Healthcare 127

GeriPal

MARCH 24, 2023

2021 Association of Hospice Profit Status With Family Caregivers’ Reported Care Experiences. I’m very proud of the work that we do every day and we take care of patients and families no matter where they live or who they are to help them meet their end of life goals. How do we make this work for patients and families?

IT 113

IT Provider Patients Family 113

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. 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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right. Jennifer: Oh nice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 9, 2023

Amber tells the moving story of how these findings led a clinical colleague, her chief, to question and change his behavior. Alex: We are delighted to welcome Amber Barnato, who’s a palliative care physician and health service researcher, and she’s director of the Dartmouth Institute for Health Policy and Clinical Practice.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

JANUARY 26, 2023

And again, that can create a food desert, which can create health issues for patients and their families, so that’s an example of structural racism, but again, it’s baked into laws. It’s baked into people’s belief systems, who ultimately make laws and make policies, and it can influence healthcare. Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

JUNE 13, 2024

And the truth is we don’t want, I don’t want any patient or family to perceive that when Brera goes to see me, there’s a second interest, a second gain. How should I define cachexia and anorexia when I’m talking to fellow students or thinking about it in my own clinical practice? There’s something.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. John: I am what I am, which is a family practice doctor. ” I think the family would like you to consider how to work with that. That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. As Sei Lee notes, the argument for developing prognostic models has won the day, and we increasingly use prognostic scores in clinical decision making.

IT 95

IT Clinic Screening Patients 95

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. Which is… In fact, I was approached by the Mayo Clinic recently.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

OCTOBER 3, 2024

How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go… The possibility of incorporating drawings in research and even clinical care. They had triple diagnoses, often life threatening illness, but also mental illness and usually some kind of addiction. That was it.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

JANUARY 11, 2024

Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. Sonu: Prior to that it was illegal and actually in the criminal code, so not only illegal, it’s actually a prohibition in the clinical code. Bill, welcome back to GeriPal.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 2, 2024

And, of course, this is what families of patients undergoing palliative care go through. But you could have clustering within clinics, within clinicians who care for a panel of patients, that sort of thing. And when I first heard the song live, I was a pool of tears and it just hits me that way.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

APRIL 18, 2024

And you say, “Okay, that’s fine, but can it really … What about a real live clinical situation?” The results were that the chat bots got the diagnoses right and had an escalation strategy that was better than the doctors, as judged by blinded specialists reading the transcripts. They had no idea.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

SEPTEMBER 19, 2024

So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 07:31 A clinical perspective, why is it important to test this stepped care model versus implementing more? And there’s a mortality number of people who just can’t make it to get to our clinic.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. Sometimes people call them health shocks, but we kind of all, like, clinically, intuitively know what these things are. Has really changed.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? The folks that we were seeing either in clinic or inpatient, were probably a lot sicker than the ones that we’re seeing now.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

JULY 6, 2023

Administration on Aging connecting you to services for older adults and their families California’s Master Plan for Aging New York’s Master Plan for Aging Transcript Eric: Welcome to the GeriPal Podcast. I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. And so this is our way of supporting non English speaking families in advanced care planning. And I have a long interest in identifying family caregivers and supporting them in care delivery.

Primary Care 79

Primary Care IT Clinic Illness 79