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

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. So no differences between the modalities.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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 96

Primary Care Diagnosis Screening IT 96

GeriPal

SEPTEMBER 1, 2022

Jennifer Temel study did not have a social worker as part of the clinical team. Eric: … social work-led research, social work-led clinical program. So … But it’s hard to let go of that clinical time. A lot of the studies coming out of there don’t have a social worker as part of the team.

IT 102

IT Families Family Clinic 102

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

JULY 21, 2022

I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. And I’ve been to some presentations that use that same breaking bad news model for having these driving conversations, as are used in palliative care. I’m going to first turn to Emmy.

Families 102

Families IT Family Diagnosis 102

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 3, 2025

It always has clinical relevance to practice today. And I also worry about this push towards just amyloid blood testing so as a way of diagnosing Alzheimer’s disease without doing the workup that’s needed beforehand. Ken 26:17 You presented that. Nancy 17:10 So there’s a follow up. And it’s.

IT 64

IT Hospital Screening Patients 64

GeriPal

OCTOBER 20, 2022

There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. And I think that’s where this clinical trial which looked at seven versus 14 days was really practice-changing for many of us. It’s very rare and they may be a male patient. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

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? So there is this meaningful difference between appropriate reactions to illness and clinically significant symptoms of mental health problems. It’s high, it’s too high.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

SEPTEMBER 22, 2022

And I think also some of the stuff we’ll be talking about, when it comes to communication, I mean, a lot of the clinical encounter is listening to the music. Tell me about the clinical enc… How do you think the uncanny valley fits into medicine and communication training and skills? What is the uncanny valley? Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

APRIL 13, 2023

Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? The Listening “EAR” approach that simplifies assessment of loneliness and social isolation in clinical settings, and other practical pointers.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

JUNE 19, 2025

You present your. But you know, the clinical piece, I think it starts out with collecting sexual orientation, gender identity in your databases. And this could be reflect or manifested in terms of your mannerisms, the way that you speak, the way that you carry yourself, the way that you. So that’s how. Just how you. Your gender.

Individual 82

Individual Community IT Chronic Condition 82

GeriPal

FEBRUARY 16, 2023

Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? 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. Welcome back to GeriPal.

Patients 109

Patients IT Families Family 109

GeriPal

JANUARY 26, 2023

Can you give us some examples, even the ones you mentioned in the paper, about how some of these structural races, like these common things that may occur in the hospital or in the clinics that we use, and we may not even think about? Ramona: Glomerular Filtration Raterate. I probably should have said GFR. Eric: Yes. I just choose GFR.

IT 92

IT Patient-Centered Healthcare Patients 92

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

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.

Families 98

Families Family Patient-Centered IT 98

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. Jane, welcome to the GeriPal podcast. Jane: Thank you for having me. John: Yeah.

Provider 117

Provider Illness IT Healthcare 117

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.

Families 112

Families Family Patient-Centered IT 112

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. First you have to be a volunteer and see what it’s like to be present at the bedside. And I said, you can’t take any photos.

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. Eric: Bill.

Illness 144

Illness IT Medical Provider 144

GeriPal

JUNE 13, 2024

How should I define cachexia and anorexia when I’m talking to fellow students or thinking about it in my own clinical practice? We have an epidemic of BMI and therefore never use the way the patient looks like to diagnose cachexia. So cachexia, I would put it involuntary weight loss is the number one way to diagnose it.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

AUGUST 24, 2023

And so the importance of the picture and the epiphany that really came many years later, I published a paper in the Journal of Clinical Oncology called Dignity in the Eye of the Beholder. How do you do that in clinical practice, in a way that doesn’t take five hours of sitting down with somebody? I’m fully present.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

SEPTEMBER 21, 2023

So what I saw in the clinical space also both in the United States and in my home country of The Bahamas just made it made sense for me to look into this a little bit more. I’m concerned about how can I get my dad diagnosed or get this proper care.” This is what they’re projecting.” It was great.

Community 128

Community Families Family IT 128

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. At a high level to sort of step in and start, you know, tinkering with workflows that, you know, are kind of as healthcare is a giant machine in primary care. We did it by the clinic level.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

MAY 1, 2025

One in 10 people with newly diagnosed HIV is an older adult. 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. Eric 16:08 Yeah.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JULY 6, 2023

I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. Eric: Which is, so let’s say I am a provider, a healthcare provider taking, let’s say a nurse practitioner working in an older, a clinic that’s mainly caring for older adults.

Community 89

Community Nurse Practitioner Provider IT 89

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.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

DECEMBER 1, 2023

Summary Transcript Summary There is a growing push to change how we define Alzheimer’s disease from what was historically a clinically defined syndrome to a newer biological definition based on the presence of positive amyloid biomarkers. So too systolic hypertension in elderly people, clinical trials. Alex: That’s right.

IT 116

IT Clinic Illness Hypertension 116

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. And it actually came up during a clinical encounter that I had. Clearly this issue is important to patients. Sharon, welcome to Jerry Powell.

Illness 130

Illness IT Physicals Patients 130

GeriPal

DECEMBER 21, 2023

Eric: And looking back at that time, what do you think the healthcare system could have done to help with that? With your journey, with your dad’s journey- Diane: They could have diagnosed him earlier. They could have diagnosed him earlier. So that’s I think diagnoses. ” Diane: Fantastic. Diane: Yeah.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

SEPTEMBER 14, 2023

JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis. That’s focused on older adults who are too frail to get into clinic. ” We put together a clinical pilot study. Annals of Int Med. Bruce: Sure.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 16, 2024

Eric Widera reminds us of the history of the Goldwater Act created by the American Psychological Association in the 1960s which states that psychiatrists should refrain from diagnosing public figures, and the American Medical Association code of ethics which likewise discourages armchair diagnosis (rule established in 2017).

Diagnosis 141

Diagnosis Diagnose IT Physicals 141