GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. And just to name a few of the more of those from the book, this is on the clinical education and training chapter.

Screening 118

Screening IT Families Family 118

GeriPal

JULY 3, 2025

We’ve invited two palliative care doctors to talk about survivorship with us: Laura Petrillo , a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker , an outpatient palliative care doctor at the Cleveland Clinic. Alex 03:45 This came up because I was in Cleveland Clinic doing grand rounds.

Patient-Centered 90

Patient-Centered Illness Clinic IT 90

GeriPal

JANUARY 18, 2024

After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise. So, we are not screening for substance use in cancer care, so we don’t get good estimates among people with cancer, which is really how we would prefer to ask the question. Katie: Yeah.

Illness 135

Illness Patient-Centered Screening IT 135

GeriPal

FEBRUARY 22, 2024

Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). We saw that around 60% of people were screening positive for depression in the last month before death. Or is it that I’m just not screening? That’s a lot.

Mental Health 121

Mental Health Patient-Centered Illness Screening 121

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 121

Patient-Centered IT Illness Patients 121

GeriPal

NOVEMBER 14, 2024

What are ways we should screen for falls? You know, if you want to think about the problem, think about clinical research. People don’t ask about it, they don’t screen about it. How do you screen or assess for risk for falls? Alex 07:27 Are there professional society recommendations or U.S.

IT 123

IT Screening Patient-Centered Community 123

GeriPal

SEPTEMBER 7, 2023

Based on this surge in evidence, the American Society of Clinical Oncologists recently updated their guidelines for care of older adults to state that all older adults receiving systemic therapy (including chemo, immuno, targeted, hormonal therapy) should receive geriatric assessment guided care. Mazie, welcome to GeriPal. William: Sure.

Patient-Centered 128

Patient-Centered IT Patients Clinic 128

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. I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

IT 101

IT Families Family Diagnosis 101

GeriPal

FEBRUARY 15, 2024

So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. I was like, “I have all these things I’m doing in the hospital to try to make people better and then I might be sending them right back to a big hazardous environment.” Eric: Oh, no.

Community 113

Community Transportation IT PCP 113

GeriPal

FEBRUARY 17, 2022

Think of the 10 years it takes to benefit from colon or breast cancer screening, which is designed to detect slow growing cancers. This tool provides a clinical recommendation for starting/stopping medications and cancer screening based on the prognosis of the patient in front of you. See screenshot below. James: Yeah.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

APRIL 3, 2025

We covered: The first parody song I wrote, for AGS 2018 in Orlando , about this article by Nancy Schoenborn on how to discuss stopping cancer screening. This was 2018 in AGS Orlando, and they did a song about when to stop screening for cancer for colon cancer. How to talk to patients about screening colonoscopies. Ken 10:29 Yes.

IT 63

IT Hospital Screening Patients 63

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. I had it on my screen. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. Welcome to the GeriPal podcast, Jennifer.

Illness 109

Illness Hospital Patient-Centered Patients 109

GeriPal

JANUARY 16, 2025

I, for example, had one patient, I remember during my fellowship, I was in geriatrics clinic and had a very well read patient who came in and was reading a New York Times article, I think in the well section at one point. Alex 16:45 That really rings true with my clinical experience. And I know I do primarily inpatient work.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. So, Alex, imagine you’re a seriously-ill hospitalized patient and I’m your doctor, unluckily for you. Eric: Either.

Consulting 119

Consulting Hospital Patient-Centered IT 119

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? So our inpatient hospitals are kind of under resourced for music therapy. It’s something that has no place in a hospital in most people’s thinking. Tyler 01:43 Okay.

IT 95

IT Patient-Centered Patients Board-Certified 95

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. Alex 00:33 Our next guest is Margaret Ross, who’s a clinical psychologist and researcher at St. Vincent’s Hospital in Melbourne, Australia.

Illness 106

Illness IT Patient-Centered Patients 106

GeriPal

APRIL 28, 2022

I’m going to share my screen and we can talk about that. And I’m just going to explain it to our listeners, what I’m seeing on my screen. So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. Eric: And this one just came out. Alex: Right.

IT 145

IT Hospital Patients Illness 145

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

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. Alex 19:12 And what’s the clinical takeaway from that?

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

APRIL 6, 2023

On the other hand, all of our guests agree that chaplains are often the most vulnerable to being cut from hospital and health system budgets. It is a screening? These hick pick codes are available to any chaplain in a healthcare system. These studies are important. I guess FICA is not as cool as SKY. Is it an assessment?

IT 98

IT Patient-Centered Families Family 98

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 98

IT Community Patient-Centered Medical 98

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. 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.

IT 136

IT Families Family Physicals 136

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Ruth: Thank you.

Nurse Practitioner 60

Nurse Practitioner Hospital Families Family 60

GeriPal

DECEMBER 5, 2024

It’s that mixture of intimacy and vulnerability, of shared clinical experiences, that fosters a sense of belonging. Alex 00:40 We’re delighted to welcome Alexis Drutchas, who is a palliative care doc at the Massachusetts General Hospital and Harvard Medical School and co founder, also of the Palliative Story Exchange.

IT 106

IT Community Patients Families 106

GeriPal

JUNE 5, 2025

And so they’re in there for a very short time, couple weeks, get a little bit stronger and transition home after a hospitalization. So they were a lot of preoccupied with other tasks, but clinical gestalt. The only time that Medicare is paying for nursing homes is in that post acute hospitalization rehab context.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. By then they usually were out of the hospital actually. Eric 10:25 And who was included?

Consulting 62

Consulting Community Patient-Centered Families 62

GeriPal

AUGUST 24, 2023

Our early studies were looking at things like, desire for death, and syndromal depression, and screening for depression and anxiety, and will to live. So tiny, tiny, in a hospital bed. How do you do that in clinical practice, in a way that doesn’t take five hours of sitting down with somebody? Eric: So how do you do that?

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. From perhaps the most sensitive instrument that we can get the family members report, while at the same time trying to sort of screen out potential false positives that are due to false hope or something like that. These are windows.

Families 92

Families Family IT Patient-Centered 92

GeriPal

DECEMBER 7, 2023

AlexSmithMD Additional links: JAMA paper on clinical research risks, climate change, and health Geriatric medicine in the era of climate change Health Care Without Harm: [link] Practice Green Health: [link] Global Consortium for Climate and Health Education: [link] Transcript Eric: Welcome to the GeriPal podcast. We really do not.

Healthcare 128

Healthcare IT Education Community 128

GeriPal

APRIL 18, 2024

And you say, “Okay, that’s fine, but can it really … What about a real live clinical situation?” I think we’re getting closer to real live clinical situations, not just answering a test. That is the first clinical use case. Bob: I think you were going to ask, what’s the first use case?

IT 139

IT Electronics Patients Healthcare 139

GeriPal

JULY 13, 2023

[laughter] Bob: That’s what happens when junior faculty get invited on the podcast [laughter] Eric: So we’re going to be talking about the article that just came out in JAMA on a priming intervention for goals of care conversations in hospitalized patients with serious illness. Three hospitals all within the UW medicine system.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

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. The HIV clinics also served as primary care. Millions of lives are at stake.

Primary Care 93

Primary Care IT Provider Clinic 93

GeriPal

FEBRUARY 24, 2022

Alex: And we’re delighted to welcome back, a frequent guest to our podcast, Rachelle Bernacki, who’s a palliative care physician and geriatrician at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital. Should we focus on something else, both from a clinical and a research perspective?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. We would admit them to the hospital. Who doesn’t want to leave the hospital? Really appreciate that.

Mental Health 122

Mental Health IT Community Individual 122

GeriPal

APRIL 21, 2022

I think that in almost every clinical encounter, we struggle with what’s ours and what’s someone else’s? I think that we forget that the clinical encounter is very often just two people in a room experiencing each other, and that that’s what is the beginning of that sacred space of healthcare and healing.”

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

DECEMBER 21, 2023

The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. Malaz: … to restrain them in the hospital. 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. And I was terrified.

Patient-Centered 124

Patient-Centered IT Families Family 124

GeriPal

JULY 20, 2023

Alex: And we’re delighted to welcome back to GeriPal podcast, Brooke Calton, who is a palliative care physician and faculty at the Massachusetts General Hospital, and is also newly the Medical Director of palliative care at Devoted Health. Joe: Great to be here. Welcome back to GeriPal, Brooke. Brooke: Thank you. How would you do that?

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73