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. But watch out! Alex 01:06 Yeah, go in person.

Telehealth 106

Telehealth Patient-Centered IT Patients 106

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 116

Community Transportation IT PCP 116

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? Let’s say, family-centered care for heart and lung disease wasn’t really going on a few decades ago.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

JUNE 19, 2025

Knowing that the community is really underrepresented in sort of our knowledge, what we do, how we provide care that’s truly inclusive and welcoming. For instance, our indigenous communities, such as some of our indigenous communities use the Term two spirit, to identify their sexual orientation and also sometimes their gender identity.

Individual 82

Individual Community IT Chronic Condition 82

GeriPal

OCTOBER 24, 2024

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 I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. Eloise, welcome to the GeriPal podcast.

Medical 100

Medical IT Patient-Centered Healthcare 100

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. Then fast forward a year.

Illness 109

Illness IT Patient-Centered Patients 109

GeriPal

OCTOBER 10, 2024

Alex 01:23 And we’re delighted to welcome DorAnne Donesky, who is a palliative care nurse practitioner at Queen of the Valley Medical center in Napa and professor emeritus at the UCSF School of Nursing. The collaboration is actually the center. If they don’t, they know how to get to community resources.

Screening 121

Screening IT Families Family 121

GeriPal

MARCH 28, 2024

And we have Kate Courtright, who’s at University of Pennsylvania, the PAIR Center. 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. Kate: These are very sick patients. Kate: Sure.

Consulting 116

Consulting Patient-Centered Patients IT 116

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. My Life, My Story: VA’s healthcare improvements through deliberate storytelling – YouTube. Storytelling Helps Hospital Staff Discover The Person Within The Patient.

Patient-Centered 116

Patient-Centered Illness Healthcare IT 116

GeriPal

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

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 133

Patient-Centered Hospital Patients IT 133

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). Rasheeda, welcome to GeriPal.

Complication 52

Complication Patient-Centered IT Patients 52

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

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient.

IT 106

IT Patient-Centered Healthcare Illness 106

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. P AI R stands for Palliative and Advanced Illness Research Center. What is sludge? Where was it?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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

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. Who would/should be on that board?

Consulting 64

Consulting Community Patient-Centered Families 64

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

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. But, should we as clinicians care about the social lives of our patients?

IT 100

IT Community Patient-Centered Medical 100

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Who follows the patient once the cancer goes into remission? I see this in the hospital when I’m doing addiction medicine consults.

Patients 74

Patients Clinic Patient-Centered Illness 74

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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.

Hospital 126

Hospital IT Patient-Centered Patients 126

GeriPal

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. Tony: Hey, thank you. Welcome to the GeriPal Podcast, Marian. Marian: Thank you. Great to be here.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

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 102

Healthcare IT Community Illness 102

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. But in the end, I see these as my patients and I’m trying to define what is the right model. How do you see the light?

Provider 119

Provider Illness IT Healthcare 119

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. Alex: And we’re delighted to welcome Sonu Gaind, who is a Chief of psychiatry and professor at the Sunnybrook Health Sciences Center at the University of Toronto.

Illness 144

Illness IT Medical Provider 144

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

GeriPal

AUGUST 1, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

IT 118

IT Diabetes Chronic Disease Patient-Centered 118

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

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 103

Healthcare Professional Healthcare IT Relationship 103

GeriPal

FEBRUARY 2, 2023

Alex: This was the National Palliative Care Research Center’s Annual Foley retreat for investigators, researchers. Bob: Well, it changed how I helped talk to people who are seriously ill and it acknowledged some of the feelings that I have and helped me be more aware of those feelings when I’m taking care of patients.

IT 105

IT Medical Student Medical Families 105

GeriPal

DECEMBER 12, 2024

Surrogates often either dont know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients. The first one is that a lot of patients, particularly the end of life, probably the majority of them, can’t make their own decisions. Good to be here.

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

GeriPal

JULY 20, 2023

Clinicians could care for patients across state lines, could prescribe opioids without in person visits, could bill at higher rates for telemedicine than previous to the pandemic. Many patients benefited, not only those isolating due to covid, but also patients in rural areas, patients who are homebound, and many others.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73