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.

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Specialization IT Patient-Centered Medical 120

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. How do you do that?

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IT Patients Individual Relationship 139

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.

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IT Patient-Centered Hospital Individual 125

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 74

Diabetes Management Patient-Centered Families 74

Physician's Weekly

JUNE 23, 2025

I witness firsthand the joy of well-child visits, the challenges and resilience of patients struggling to control their diabetes, and the Medicare annual wellness visit, all of which represent the collective effort to safeguard individual and community well-being. Outbreaks become more likely, and disease spreads more easily.

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Vaccination Community Individual Illness 80

PEMBlog

OCTOBER 2, 2024

I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. Gastroesophageal reflux disease is when the patients have severe symptoms that persist and cause long term issues.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

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.

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Vaccination Medical Student Patient-Centered Community 73

Mesa Family Physician

MARCH 13, 2025

However, at Mesa Family Physicians , we believe that preventive healthcare is the cornerstone of long-term wellness for our Mesa, Arizona community. For Mesa residents dealing with these ongoing health challenges, regular visits to Mesa Family Physicians ensure that your condition remains well-controlled and complications are minimized.

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Family Physician Preventive Care Preventative Care Family 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. .

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Community IT Mental Health Medical 97

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. I encourage all my patients to prioritize these visits, even when feeling perfectly healthy.”

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Preventive Care Preventative Care Appointment Screening 100

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. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

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Patient-Centered IT Illness Patients 123

GeriPal

MARCH 9, 2023

Early data on efficacy in patients with anxiety and demoralization are promising. 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). Research is exploding. You’ve been trained?

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Patient-Centered Community IT Medical 91

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. But the patient would say, well, but it still hurts, though.

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Illness Patient-Centered Patients IT 134

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.

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Complication Patient-Centered IT Patients 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

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?” Lynn: I do. Alex, can you play Send the Sun, by Nikki Lane?

Families 98

Families Family Patient-Centered IT 98

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers.

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Illness Hospital Patient-Centered Patients 111

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then one patient who really knew more about a topic than I did, which unfortunately happens much more often.

Medical 100

Medical IT Patient-Centered Healthcare 100

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? Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery. AlexSmithMD.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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. Young adulthood is super hard.

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IT Families Family Illness 83

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.

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Patient-Centered Hospital Patients IT 133

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.

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IT Patient-Centered Patients Board-Certified 98

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.

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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? Where was it? Eric 06:24 Yeah.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. Initially, it was just because there weren’t really answers for my patients. 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.

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Families IT Family Diagnosis 102

GeriPal

OCTOBER 19, 2023

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. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

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.

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Patient-Centered IT Hospital Patients 78

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades.

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Illness IT Medical Provider 144

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.

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Families Family IT Patients 107

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.

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Healthcare IT Community Illness 102

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. Who would/should be on that board?

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Consulting Community Patient-Centered Families 64

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. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

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Hospital IT Patient-Centered Patients 126

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. He looked very ill. But in the end, I see these as my patients and I’m trying to define what is the right model.

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Provider Illness IT Healthcare 119

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 116

Consulting Patient-Centered Patients IT 116

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. I’ve had a patient in one room, they have stage four breast cancer. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study.

IT 137

IT Families Family Physicals 137

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. GeriPal podcast with Linda Fried on frailty.

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Patient-Centered Patients IT Illness 96