GeriPal

JUNE 20, 2024

Incontinence and avoiding issues can present in an older individual, in some cases, just like they do a younger person. Biological aging or physiological aging varies from individual to individual. How do you think about this from a clinical perspective when you’re seeing individuals in your office? Everybody ages.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

JUNE 8, 2023

-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 74

Diabetes Management Patient-Centered Family 74

GeriPal

MAY 11, 2023

The beautiful thing about it, it’s more than just having a career development award; it’s a community of aging researchers. One of the highlights really is the networking and the community that it fosters and highlighted, in some ways, by the meeting, which of course you often lead the sing along at. I agree with you.

Physicals 86

Physicals IT Hypertension Education 86

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

Vida Family Medicine

JUNE 29, 2022

A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms. The healthcare system must provide care in a just way so that those who need care have access to it. What Roe v.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

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

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. They came from other traditional settings and communities that have a lot of knowledge about how to use them in respectful and safe ways.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

OCTOBER 20, 2022

How HHS and ASPE solicit input from clinicians, community leaders, and older adults and how much it impacts policy decisions (spoiler alert: this involvement is CRUCIAL). There’s a team now with them behind them making sure that they stay safe and held in our communities. How to make your voice heard and get involved.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JULY 21, 2022

But then once it was open, started seeing a lot of other populations: not just our own hospital population, but a lot more just community members calling with concerns about driving. If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. Eric: Yeah. Alex: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JANUARY 25, 2024

In their communities? It used to be a much more complicated model. However, its main predictors are age, comorbidity, and healthcare utilization. As a nurse, how challenging would it be to do eight hours of training and jump into this complicated world? With their regular providers? David: Right. David: Yeah. Eric: Okay.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 88

Vaccination Individual IT Healthcare 88

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. You have a patient with dementia severe enough that she cannot recognize relatives.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. We lump everybody who’s 65 and older together, and then we don’t look at the individual characteristics of that person, so we fall into these patterns based on racial premises.

IT 92

IT Patient-Centered Healthcare Patients 92

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. The social determinants of health and what community well being was a big part of. those experiencing homelessness).

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 4, 2023

Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. The whole idea of holding hope seems also so much more complicated for younger people because the hopes that they had, the normal hopes are not likely to be realized. What are the patients that we remember? Abby: Yeah.

IT 83

IT Family Families Illness 83

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 Eric Widera. Not anymore.”

Family 98

Family Families Patient-Centered IT 98

GeriPal

MAY 15, 2025

Many were community hospitals. We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. We tested two different nudges individually and then we combined them. I highly encourage you.

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

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

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

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

MARCH 7, 2024

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. That was really the theme song of how the community came together. It sets space between us and the individuals we’re trying to take care of. How do you see the light? Again, I go back to this.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MARCH 24, 2022

Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. So it’s an example of something that can start outside of the healthcare system and move its way in. And the reality is they don’t.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

DECEMBER 14, 2023

There’s obviously private hospitals, academic hospitals, community hospitals. And so the combination of the institutional structures, as well as the extreme cases that each individual doctor feels will actually help create this different culture, be it high or low intensity. Did we really do right by this person as an individual?

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

AUGUST 25, 2022

Eric: If I remember your article correctly, there was maybe some better things with for-profits, like more community engagement with low-income communities and more engagement with minority communities. Melissa: The other scenario that exists is just disenrollment because an individual is hospitalized.

Family 106

Family Families IT Patients 106

GeriPal

FEBRUARY 8, 2024

So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? Of course, there’s psychedelics. There’s mind-body medicine.

IT 137

IT Family Families Physicals 137

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

OCTOBER 26, 2023

And so for pt, we’re generally focused on assistance with transfers, providing assistive devices to help people maintain independence with ambulation, doing stairs, leaving their homes, getting into the community, but really focusing on symptom management. And oh, guess what? Ann: Yeah, I’ll let Tamra speak if you want.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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. So it started off for individuals with a terminal illness. And making most I can do, I can use my mouth even though I only have six fingers here.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 28, 2022

So at least in my oncology community, I really didn’t have anyone guiding or supporting or mentoring me. Jennifer: I think it’s such a complicated question. And for the most part, it’s really hard to start building an evidence base in the community setting. But we need to start building an evidence base.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 19, 2023

There are differences, but I think you could make a credible argument that good high quality communication with patients is a great thing and we don’t need POLST or advanced directives to make it a better thing. Eric: That’s a complicated form then. So we have the intervention is a big part. You write who the surrogate is.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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. Holly: Oh absolutely. Holly: They’re the same symptoms.

IT 100

IT Complication Relationship Specialization 100

GeriPal

MARCH 3, 2022

So, for the two studies, I’ll mention, we use data from the precipitating events project at Yale, which is Tom Gill’s amazing cohort, where they followed a cohort of initially non-disabled community dwell and older adults with monthly measures of function. I think it’s really, really complicated. Alex: Bye everybody.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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. This is a particularly interesting topic because we know that individuals with dementia have a high rate of entering nursing home. So you’re kind of the guest host today.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MAY 1, 2025

So it felt like it was being part of this huge kind of change in the whole environment and the whole experience of that community. And, you know, I’ve seen that some primary care providers, there’s still so much stigma that they don’t feel comfortable or they feel like that managing HIV is somehow too complicated.

Primary Care 94

Primary Care IT Clinic Provider 94

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. And is it at all individualized to the patient? It’s a lot.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79