Vida Family Medicine

JUNE 29, 2022

These are intellectually interesting but often personally devastating to the patient and family involved. The healthcare system must provide care in a just way so that those who need care have access to it. All physicians are trained in medical ethics, but I have always taken a particular interest in this field.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

GeriPal

FEBRUARY 15, 2024

So Carmen and Katie developed an EMS Community Partnership program. They created a seamless link between this Community Partnership program and 911 calls for falls. Eric and I enjoyed talking with Carmen and Katie about this innovative and common sense approach to addressing falls in the community. What can we do as a community?

Community 115

Community Transportation IT PCP 115

GeriPal

NOVEMBER 14, 2024

If you want to do a deeper dive into some of the articles we discuss, take a look at the following: An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults. Sarah 03:57 Yeah, it’s a pretty big problem for older adults, I’d say in community dwellers. It’s one out of two.

IT 124

IT Patient-Centered Screening Community 124

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. And the sort of the ask was, “Oh yeah, you can talk to the family, right?

Family 98

Family Families Patient-Centered IT 98

GeriPal

MAY 25, 2023

Sarah Nouri, Hillary Lum, and LJ Van Scoy argue that diverse communities are asking for ACP. Sarah Nouri gives an example from her work in the LGBTQ+ community of a trans woman who was buried as a man because existing laws/rules did not protect her wishes. Complicated grief? Did the caregiver feel heard and understood?

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Were those people self referring, or family members calling you asking? Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

MARCH 9, 2023

Psychedelics have been used by communities around the globe for hundreds of years (or more). Alex: It’s complicated. We, for very complicated reasons, ended up with niacin. The efficacy of psychedelics without therapy, and the impact of variations in therapy type, training, duration, is unknown. Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. In their communities? I was really passionate about helping the people and also their families.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous.

IT 83

IT Family Families Illness 83

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. Eloise 10:29 Yeah, I think what we saw in California was, prior to legalization, there was curiosity, but also a lot of their healthcare professionals didn’t know enough about it, so they didn’t discuss it with them. Is that your feeling, too?

Medical 99

Medical IT Patient-Centered Healthcare 99

GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

MAY 12, 2022

Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . And I believe it needs the community. Raj: So in Kerala, because it started with the involvement of laypeople, we included the community in care because the existing system had no space for this.

Community 115

Community IT Relationship Healthcare 115

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? She falls and breaks her hip. She has advance dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

FEBRUARY 8, 2024

They’re starting to decompose even in the toes and fingers, and we’ll sit there and tell their family, we think they’re suffering, because we are suffering watching them, and we want them to make a decision that’ll make us feel better and take the suffering away as quickly as possible. What are you seeing?”

IT 137

IT Family Families Physicals 137

GeriPal

MAY 22, 2025

And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience. We introduce it to families and patients and explain how it works and show them. Relationships are usually more complicated.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

MARCH 24, 2022

And especially for those who may have nontraditional families. I think if you’re from a nontraditional family, it’s very important to make sure that people understand who you would want to talk to. So it’s an example of something that can start outside of the healthcare system and move its way in.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

FEBRUARY 13, 2025

We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Eric 04:27 Yeah, I gotta ask about the community advisor. So I don’t want my Marin community to.

Consulting 63

Consulting Community Patient-Centered Family 63

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.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

AUGUST 25, 2022

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. It’s really a pretty traumatic experience for a lot of patients and families. And I had a blast playing Take the Money and Run!

Family 106

Family Families IT Patients 106

GeriPal

MAY 15, 2025

Many were community hospitals. And so we simply asked clinicians, have you offered this patient and, or their family the option of care focused on comfort? Because it’s complicated and we don’t want to over complicate prayer listeners. Their family members want them to get out of the hospital sooner.

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

GeriPal

DECEMBER 14, 2023

It’s the clinicians on the rounding team, yes, but also the multidisciplinary team is really important, how they support the patient, the family, the doctors, the nurses, but also how the broader institutional structures such as ethics committees, et cetera, how they support. And then was trying to find different hospitals.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MARCH 30, 2023

Today we’re going to be talking about narrative writing specifically for healthcare professionals. Then in the OpenNotes work that I do, I was hired to take something complicated like transparency and patients having access to their full records in medicine, and then making that something that the lay public understood.

IT 96

IT Patient-Centered Patients Healthcare 96

GeriPal

MARCH 6, 2025

Michael’s Hospital in the Department of Family and Community Medicine. The social determinants of health and what community well being was a big part of. I always knew that I wanted to get into healthcare, to use healthcare as a springboard for social change in our communities.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. We provide critical conversations with colleagues and families to coordinate transition planning.” And oh, guess what?

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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. And then second, I was someone who was a Parrot Head for years and years and it was just amazing how the community came together. How do you see the light?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JUNE 13, 2024

We need this type of push to make us feel that we are part of a community and we are part of a movement and things are changing because we are around. 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.

Illness 133

Illness Patient-Centered Patients IT 133

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. So at least in my oncology community, I really didn’t have anyone guiding or supporting or mentoring me.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

APRIL 10, 2025

So Tammie developed something called EPIC for Emergency medicine, which is a curriculum that was one of the first ways that I think palliative care got spread in our community. We adapted a small group of us, Vital Talk for emergency medicine, which is communication skills training using simulation. But yeah, it’s complicated.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MAY 26, 2022

There were community-minded motivations, there were motivations that were not having to do with health but having to do with, “So my kids won’t keep calling me and telling me I have to get vaccinated,” type motivations so. I think in other cases, if you look at surveys, the motivations can be more complex.

Vaccination 88

Vaccination Individual IT Healthcare 88

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. Eric: That’s a complicated form then. Karl: Okay. Karl: You can write it in.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MARCH 28, 2024

None of the changes that we saw in end-of-life care processes relied on specialist palliative care increases or resources, which is really important because seven of the 10 hospitals that participated were rural or community-based, which is where most Americans receive their care, and also where specialist palliative care is often most limited.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

MARCH 3, 2022

When patients leave the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits. You can use that when you’re talking to families about prognostication. Alex: What happens when people survive? It’s not just about the ICU.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

SEPTEMBER 8, 2022

It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Eric: Is that the same as complicated grief? We say it’s about 4% of those who are bereaved, who are from community-based samples. They don’t want to interact with their family.

IT 100

IT Complication Relationship Specialization 100

GeriPal

JANUARY 11, 2024

So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. The first one is I would want the general public and healthcare professionals to really understand actually what natural dying and death look like.

Illness 144

Illness IT Medical Provider 144

GeriPal

NOVEMBER 3, 2022

You’d imagine though that our professional expertise and experiences in helping patients and families cope with loss and grief would be helpful in managing our own personal losses. These debriefings create a safe outlet for health care professionals to talk about the feelings resulting from their work. Turns out, it’s maybe not.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

GeriPal

JULY 25, 2024

Next, we talk with James Deardorff about whether we can accurately predict nursing home level of care in community-dwelling older adults with dementia. And just like cultural background, there are some individuals and families that would really never have their loved one enter a nursing home, choosing instead to take care of them.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MAY 1, 2025

Alex 00:07 We are delighted to welcome Peter Selwyn, who is a family medicine and palliative medicine doctor and chairman of the Department of Family and Social Medicine and director of the Palliative Care Program at Montefiore E instein and author of Surviving the the Personal Journey of an AIDS Doctor. Who are our guests?

Primary Care 94

Primary Care IT Clinic Provider 94