Mesa Family Physician

MARCH 6, 2025

Unlike appointments that address specific illnesses or injuries, preventive care visits focus on screening for potential health issues, assessing your overall wellness, and helping you establish healthy habits before problems develop. “Are there specific health risks I should be aware of based on my personal or family history?”

Preventive Care 100

Preventive Care Preventative Care Appointment Screening 100

GeriPal

NOVEMBER 17, 2022

Assisted Living Communities (no longer preferable to call them Assisted Living Facilities, as we learned on the podcast) are…what, exactly? If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. . If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. .

Community 97

Community IT Mental Health Medical 97

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. In their communities? The article we discuss today, also published in JAMA , addresses these two gaps. There has to be more than this.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. Thank you for that gift to our community and to the patients.

Illness 134

Illness Patient-Centered Patients IT 134

GeriPal

MARCH 9, 2023

Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). Psychedelics have been used by communities around the globe for hundreds of years (or more). Alex: It’s complicated.

Patient-Centered 91

Patient-Centered Community IT Medical 91

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?

Families 98

Families Family 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

MAY 4, 2023

There’s all this stuff that we’re supposed to be doing at that stage of life and then you add the complexity of the serious illness. 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.

IT 83

IT Families Family Illness 83

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). Love to talk about also in the serious illness population. “Do you guys do this?”

Families 102

Families IT Family Diagnosis 102

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

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . And especially for those who may have nontraditional families. This is Eric Widera.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Transcript. Eric: Yeah.

Illness 111

Illness Hospital Patient-Centered Patients 111

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 116

Community IT Relationship Healthcare 116

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Many were community hospitals. Participants were critically ill and intubated. What is sludge? Eric 01:01 So we got a good topic today.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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. And so I knew that I wanted to do something related to palliative care because I work with people with advanced and serious illness.

Patient-Centered 133

Patient-Centered Hospital Patients IT 133

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. So we’re going to be today talking about serious illness palliative care in the homelessness population.

Healthcare 102

Healthcare IT Community Illness 102

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Family member, and with some chagrin- Eric: Powerful nudge. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. 2023.11.004.

IT 137

IT Families Family Physicals 137

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 64

Consulting Community Patient-Centered Families 64

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. In fact, as Lauren Hunt found , the average likelihood that a person will be disenrolled from one hospice vs. another is two.

Families 107

Families Family IT Patients 107

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. He looked very ill.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

DECEMBER 14, 2023

On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. And so I specifically chose hospitals that were at different intensities of care based on the Dartmouth Atlas around serious illness and end-of-life care.

Hospital 126

Hospital IT Patient-Centered Patients 126

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. But that was separate from MAID.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. 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. Relationships are usually more complicated.

IT 98

IT Patient-Centered Patients Board-Certified 98

GeriPal

OCTOBER 19, 2023

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. What I’m saying is the entire field of serious illness care has for decades been plagued by a really weak evidence base.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness. Eric 45:24 Yeah.

Medical 100

Medical IT Patient-Centered Healthcare 100

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. Alex: What happens when people survive? Lauren: Yeah. Lauren: Yeah.

Patient-Centered 96

Patient-Centered Patients IT Illness 96

GeriPal

MARCH 28, 2024

Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. I am part of some other work in the ICU world looking at time-limited trials and trying to better define what those are, how we talk about them, how we talk about them with patients and families. Kate: Sounds right. Eric: Okay.

Consulting 116

Consulting Patient-Centered Patients IT 116

GeriPal

SEPTEMBER 8, 2022

Alex: Their own death in advance, terminally ill people. 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.

IT 100

IT Complication Relationship Specialization 100

GeriPal

JUNE 6, 2024

Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. So we got a lot to cover on sexuality, sexual health, and serious illness. I think this is a topic we don’t talk about as much in the context of serious illness. Don, welcome to GeriPal. Don 01:11 Thank you so much.

Illness 131

Illness IT Physicals Patients 131

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. Next, we talk with James Deardorff about whether we can accurately predict nursing home level of care in community-dwelling older adults with dementia.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MARCH 27, 2025

The reason I chose this song is because I’m currently working on bringing advanced care planning sessions to the Latino community. In our planning sessions, one of the biggest barriers to advanced care planning in this community is just talking about death. I’m hearing family and caregivers. Eric 02:32 Great, Alex.

Primary Care 80

Primary Care IT Clinic Illness 80

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 96

Primary Care IT Clinic Provider 96

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. And it was so obvious that when loss affected a person in a family, that women experienced it very differently. Turns out, it’s maybe not.

Healthcare Professional 103

Healthcare Professional Healthcare IT Relationship 103

GeriPal

SEPTEMBER 14, 2023

If you are interested in learning more and meeting a community of folks interested in hospital-at-home, check out the hospital-at-home user group at hahusersgroup.org or some of these publications: Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. How is it financed and what comes next?

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

PEMBlog

DECEMBER 4, 2024

Aside from coughing forever, there’s some important complications you need to be aware of. So respiratory complications include apnea, secondary bacterial pneumonia, and pulmonary hypertension. And you definitely have to watch those kids very closely for the complications such as hypoxia and secondary infections.

IT 52

IT Vaccination Diagnosis Complication 52

GeriPal

JUNE 2, 2022

Eric: All right, before we start talking about COVID in older adults and those with serious illness, do you have a song request for Alex? I’m wondering if we can start off with thinking about the prevention of COVID in older adults and those with serious illness and then potentially the management of them. Eric: I loved all that.

Vaccination 100

Vaccination IT Hospital Management 100