GeriPal

FEBRUARY 6, 2025

Eric 00:27 So we’re going to be talking about making the diagnosis of Alzheimer’s disease in a primary care setting, not specialty care, but maybe we could talk a little bit about that. How much should it change how we think about making a diagnosis of Alzheimer’s disease in primary care? Great to be back. Absolutely.

Primary Care 96

Primary Care Diagnosis Screening IT 96

GeriPal

JUNE 27, 2024

The question I would ask is, how helpful is that in our clinical practice? If they’ve said they had a traumatic experience receiving a diagnosis. And so in terms of, am I looking to put a DSM diagnosis to someone? What would be the benefit to myself, or hopefully for them to add a DSM diagnosis? I wonder why?

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

OCTOBER 24, 2024

And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. I’d been a nurse at the time, and I went back to do my clinicals in an oncology clinic locally. And I decided at that point to hang a shingle and start a clinic with a physician.

Medical 99

Medical IT Patient-Centered Healthcare 99

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. Often when there’s a cognitive concern, it’s a family member that is calling saying, “I just want to make sure my mom should still be driving after this happened, or after this diagnosis.”

IT 102

IT Family Families Diagnosis 102

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 Family Families Clinic 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

JULY 11, 2024

Can you come and be in our clinic once a week? It used to also be a social worker and myself who would actually go to clinic and spend some time up there. And so I was driven by the fact that I needed more information, and so it sort of became my clinical focus as well as I dabble in the research.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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? We might say, “Of course you’re sad, you just got a very serious diagnosis.” It’s high, it’s too high. Or is it that I’m just not screening? Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. And this has been really interesting because people are like, they just got their diagnosis.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

OCTOBER 20, 2022

How we came about to select these articles or to have interest in this topic is really older adults are unique population that are at risk for both over diagnosis of infections as well as under diagnosis of infections. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations.

Complication 52

Complication Patient-Centered IT Patients 52

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. Eric 12:05 Any pearls on the diagnosis of HFpEF. Alex 00:12 We have a guest host who has requested this episode, Matt Shuster, who’s a geriatrician and palliative care doc.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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

OCTOBER 12, 2023

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? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Family Families Patient-Centered 128

GeriPal

JUNE 19, 2025

You present your. When you have, when you exist simply for being you, and then on top of that you have HIV AIDS as a diagnosis or substance use or what have diabetes, all of these will accelerate your aging. But you know, the clinical piece, I think it starts out with collecting sexual orientation, gender identity in your databases.

Individual 82

Individual Community IT Chronic Condition 82

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

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 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 Family Families 109

GeriPal

DECEMBER 19, 2024

Eric 07:03 Yeah, it’s hard because you can also think about it, let’s say, because we see palliative heart failure clinics. So people like palliative cardiology clinics where honestly, heart failure management is a lot of symptom management. I think it’s very present in maid. So it’s a lot of palliation.

Illness 101

Illness Mental Health IT Patient-Centered 101

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: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. When it’s itself as an intervention, I think that’s where problems arise.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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. Is a new diagnosis of HIV. If they did, it was before AIDS was a diagnosis.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JULY 6, 2023

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. 60% of all medical costs have nothing to do with your health diagnosis. And then, the system responds in turn.

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. 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 Patient-Centered 79

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

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. This is Eric Widera.

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. So this is about two and a half, three years out from leukemia diagnosis.

Illness 130

Illness IT Physicals Patients 130

GeriPal

FEBRUARY 24, 2022

Should we focus on something else, both from a clinical and a research perspective? That this is iterative from diagnosis to end-of-life, right? But one of the things that I try to teach, because both Juliet and I have done a ton of teaching about this, is that if you follow these steps, that outcome sort of presents itself.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

DECEMBER 21, 2023

But what happened when we finally… When he did get the diagnosis, it all fell into place. So IU, we have been able to convert our paper, Chris Callahan paper that was published in 2006, the first clinical trial that was positive. So what that means is I take care of you just in my clinic, just in my hospital. Diane: Yeah.

Patient-Centered 125

Patient-Centered IT Family Families 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

Ken Covinsky reminds us that we should not be making a diagnosis based on what we see on TV, and that if a patient’s daughter expressed a concern that their parent “wasn’t right,” we would conduct an in depth evaluation that might last an hour. Cecilia Poon says, what are some best practices to highlight professional ethics?

Diagnosis 141

Diagnosis IT Diagnose Physicals 141