GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. This is like, back in 2013, and I joined the faculty at the Icahn School of Medicine at Mount Sinai.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

OCTOBER 10, 2024

For instance, a family meeting or an update or communication with families. I’ve worked in palliative care for years, and there’s some times where I’m in the family meeting, I’m facilitating the family meeting, and then I’m reporting out to the referring doctors, and I say, what happened?

Screening 119

Screening IT Family Families 119

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 97

Family Families Patient-Centered IT 97

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

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. You get a consult if you get a consult.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. 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. Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team.

IT 83

IT Family Families Illness 83

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. It’s by choice, just like in the community. In many cases, the families were the victims of the crime. Michele: Thank you for having me. Michele: Yep.

Family 132

Family Families IT Community 132

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. You did a rural tele-palliative care consultation study. NCP guideline, standard consultation.

Consulting 63

Consulting Community Patient-Centered Family 63

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

MARCH 28, 2024

It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality. Kate: I think the main one for me being asked on the fly is that one of the nudged specialist palliative care consultation, which we know has limitations. Eric: So how do you put that all together? Eric: Okay.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

OCTOBER 24, 2024

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. For instance, Friday night, Saturday night parties are of community wide. Is that your feeling, too?

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. They didn’t feel connected to the people in their broader community.

IT 99

IT Community Patient-Centered Medical 99

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. Tamra: I wrote this… Eric: Thinking that the perceived role for inpatient physical therapist is a discharge consultant.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JUNE 5, 2025

Kathleen 03:47 I think any of us who’ve spent any time in nursing homes have spent time working in a nursing home setting, have visited, had family members in nursing homes and looked around and seen the population there. So we see a lot of problems with symptom management, a lot of family conflict. That’s a big question.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And there are no default pathways of family or friends to rely on and no known people who could potentially represent this person from within their inner circle.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

DECEMBER 15, 2022

So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live. So those questions we ask when we’re doing a palliative care consult.

IT 105

IT Patient-Centered Healthcare Illness 105

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

APRIL 28, 2022

Here’s another clinician saying, “I ignored a patient’s tears and gave a speech about cardiac physiology during a family meeting.” I was just thinking back to yesterday, we were in a family meeting. Did they ask for a consult?” That’s scare tactics. Definitely puts you in palliative care jail.

IT 145

IT Hospital Patients Illness 145

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. What is sludge? Sludge is apparently when you create barriers or extra work for someone. If not, why not?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

MARCH 24, 2023

2021 Association of Hospice Profit Status With Family Caregivers’ Reported Care Experiences. I’m very proud of the work that we do every day and we take care of patients and families no matter where they live or who they are to help them meet their end of life goals. JAMA Health Forum. Eric: Great. Now it’s 70%.

IT 113

IT Provider Patients Family 113

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

DECEMBER 5, 2024

So we take that science and we apply it to something that’s very messy and chaotic, like a human being or a community or a population. I think it started off from a need, a hunger in the community. There’s obviously a lot of flaws in the healthcare system. A love letter kind of back to my community.

IT 107

IT Community Patients Family 107

GeriPal

JUNE 30, 2022

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 wasn’t communicating, she couldn’t remember anybody’s name, nothing. She has advance dementia. Eric: So, let’s talk about that. They would be horrified.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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

APRIL 10, 2025

I think that study was really important, especially I think the message that I give people is you can do something as simple as calling a consultation and improve quality of life months later. We adapted a small group of us, Vital Talk for emergency medicine, which is communication skills training using simulation. And so we use that.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

OCTOBER 6, 2022

Alex: And we’re so delighted to welcome to the GeriPal Podcast Marian Grant, who is a palliative care nurse practitioner and marketing consultant, and she is at the University of Maryland Medical Center in Baltimore. Welcome back to GeriPal, Tony. Tony: Hey, thank you. Welcome to the GeriPal Podcast, Marian. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

MARCH 10, 2022

The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. Whereas the home with the low rate of feeding tube use involved families in decision making. Whereas the high-intensity nursing homes tended not to have a process or did not include families. There was a hesitancy to engage black families.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

JANUARY 11, 2024

What happened is that firstly, in terms of my clinical background, my background is psycho-oncology, so that’s working with patients with cancer and their families, including when they’re going through periods. So being well and also potentially periods of dying. But that was separate from MAID. Eric: Thank you Bill.

Illness 144

Illness IT Medical Provider 144

GeriPal

SEPTEMBER 19, 2024

Alex 10:53 Yeah, or like palliative care if they get a consult for whatever reason, but not trn consult, like standardized, you know, randomized to palliative care versus whatever they’re doing before. If they get palliative care consult, they get one. If they don’t, they don’t. It’s not case finding.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

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. Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. And since starting the clinic, median time for consult to death was. Alex 10:40 Wow.

Family 106

Family Families Patient-Centered IT 106

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

BMJ

AUGUST 20, 2021

By John Scott Frazer, Glenn Ross Frazer Reference : Frazer JS , Frazer GR, Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model, Family Medicine and Community Health 2021; 9: e001143.

Primary Care 40

Primary Care Supply Chain General Practitioner Vaccination 40

GeriPal

AUGUST 1, 2024

People are coming from the south, they’re coming from the islands for their surgeries or for their rare disease consultations or their specialty follow ups for really advanced or difficult cases. Well, the irony is that this diethye resurrected from the poorest communities in the mediterranean region. Anna 27:19 This is it.

IT 116

IT Diabetes Chronic Disease Patient-Centered 116

GeriPal

FEBRUARY 2, 2023

For example, is reluctance to take on more responsibility at work or relocate because you feel inadequate or is it because of genuine concern about the impact on your family? I think we’re really good at that as palliative care doctors when we’re dealing with families. You need to be different.

IT 104

IT Medical Student Medical Family 104

GeriPal

DECEMBER 12, 2024

You basically don’t even ask the family, you just stop the bleeding. Are you encountering family members who are just, like, at a loss for what to do and tortured it? Patients who are sort of estranged from family members who then have to make these decisions for somebody that they don’t really know.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

GeriPal

JULY 20, 2023

And I think that it was percolating in a lot of the palliative care community. But in California where I practice medical aid and dying is legal and similar to other issues that are controversial in some places, many physicians do not prescribe or do visits for medical aid and dying consultations. Eric: Well, can I ask about that, Joe?

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73