GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 124

IT Patient-Centered Hospital Individual 124

GeriPal

JANUARY 23, 2025

Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes. Patients received brochures detailing the risks of gabapentinoids, nonpharmacologic alternatives, and a proposed deprescribing regimen (see here for the brochure ). in the usual care group.

Specialization 119

Specialization IT Patient-Centered Medical 119

PEMBlog

AUGUST 20, 2024

ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. The episode highlights the importance of understanding eCPR as a critical therapy for both in-hospital and out-of-hospital cardiac arrests.

Patient-Centered 52

Patient-Centered Hospital Patients IT 52

PEMBlog

SEPTEMBER 24, 2024

At that point, he was referred to pulmonology who started the patient on albuterol, manual chest physiotherapy, and a steroid inhaler with a plan for a fourth chest x-ray four weeks later. On arrival, the patient was febrile to 38.3C. Bronchopulmonary sequestration Our patient was diagnosed with bronchopulmonary sequestration (BPS).

Diagnosis 52

Diagnosis Diagnose Patients Asthma 52

GeriPal

JULY 19, 2024

What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. We talk about diagnosis, et cetera, but it’s almost more of a community conversation. Why would we want to?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MAY 19, 2022

A patient is on morphine and you want to convert it to another opioid like hydromorphone (dilaudid). Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. Step four is adjusting it for your patient.

IT 139

IT Patients Individual Relationship 139

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 73

Diabetes Management Patient-Centered Family 73

The Clinical Problem Solvers

APRIL 5, 2022

Bobby Watts about what brought them into their fields, how their work reaches the most marginalized, and what can be done at the community and structural level to address homelessness. Our guests remind us to ask our patients about their housing status using non-judgmental and non-stigmatizing language. Know your community resources.

Community 52

Community Patient-Centered Emergency Room Medical 52

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

Doctors for America

MAY 30, 2025

As physicians, we know that access to these evidence-based tools to prevent severe illness, disability, and death, are essential to the care of our patients and our shared goal to improve the health of all Americans. Millions of Americans continue to live with complications of this disease and long COVID.

Vaccination 65

Vaccination Medical Student Patient-Centered Community 65

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. Going into patient’s homes was eye opening. So Carmen and Katie developed an EMS Community Partnership program. Word of mouth spread rapidly.

Community 114

Community Transportation IT PCP 114

GeriPal

NOVEMBER 14, 2024

Patients may feel like falls are just part of normal aging. 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. I think both the patients feel that. It’s one out of two.

IT 124

IT Patient-Centered Screening Community 124

GeriPal

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. Your research is a lot in this patient population, right? In their communities? The article we discuss today, also published in JAMA , addresses these two gaps. Big randomized control study that came out.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

Vida Family Medicine

MARCH 28, 2024

As a primary care physician, I am asked about these medications at least once a day, either by a patient, a colleague, a family member, friend, or acquaintance. As most of you know, I follow a Health at Every Size® approach to the care of my patients. Sometimes, for some patients, the GLP-1 receptor agonists may be the best choice.

Diabetes 52

Diabetes Primary Care Physician Medical Patients 52

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? 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). Sonali: Thank you for having me.

Patient-Centered 52

Patient-Centered Complication IT Patients 52

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” That’s a huge amount of news all at once. Lynn: I do.

Family 97

Family Families Patient-Centered IT 97

GeriPal

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. William: Thanks so much.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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 95

Community IT Patient-Centered Primary Care 95

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. The intervention was a negative study for the primary outcome, hospital length of stay.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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. 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.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Joel: The Brigham and Women’s Hospital likes me to say that too. And she was rushed to the hospital.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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 77

Patient-Centered IT Hospital Patients 77

GeriPal

MAY 12, 2022

Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission.

Community 115

Community IT Relationship Healthcare 115

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Initially, it was just because there weren’t really answers for my patients. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. How did you get interested in this?

IT 102

IT Family Families Diagnosis 102

GeriPal

MARCH 28, 2024

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. And that’s it. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

PEMBlog

JUNE 2, 2025

Upon entering the room, you find the patients nurse at the bedside already in mid-conversation with the patients parent. In pediatric patients, this condition should be considered when blood pressure exceeds the 95th percentile for age, height, and sex by more than 30 mm Hg, or reaches levels above 180/120 mm Hg in older adolescents.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Caveat as well that RCTs should not be placed on pedestal as the only answer- often patients enrolled in RCTs do not represent real world patients – observational studies do. This is Eric Widera.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

JANUARY 26, 2023

Ramona: Well, I’ve always been interested in health equity, always been interested in looking at disparities, and the disparities that I have looked at most often have been for patients at the end of their lives. The trainee said to me something like, “But I haven’t seen any geriatric patients yet.” Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for.

IT 83

IT Family Families Illness 83

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. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Family 106

Family Families IT Patients 106

GeriPal

MARCH 30, 2023

Liz wrote a fabulous perspectives piece in the NEJM titled “ Deciding on My Dimples ” which talks about her experience as a patient doing shared decision making during neurosurgery for resection of an astrocytoma. But my piece in the New England Journal is about being a patient right before awake brain surgery. I could learn this.

IT 95

IT Patient-Centered Patients Healthcare 95

GeriPal

MAY 26, 2022

Emily: And so even in the pandemic, we’ve seen circumstances like this where hospitals wrote allocation policies that were going to give preference to frontline healthcare workers in hopes, right, that they would incentivize them to stay on the job knowing that they would be taken care of and because they had been working for the public good.

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. 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. And this is really traumatic event for his street family and the street community that he knew.

Healthcare 100

Healthcare IT Community Illness 100