GeriPal

DECEMBER 2, 2022

Her most recent book is Dementia Friendly Communities: why we need them and how we can create them . He wrote a book titled “ Psychiatric consultation in long term care ” that has a strengths based approach to staging dementia (how cool is that). And that’s why we need this community support, I think. Transcript.

Community 102

Community IT Individual Patient-Centered 102

GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

APRIL 27, 2023

“What we’ve seen to make it really work is you either have to be in the hospital, where we’ve taken over palliative care in the hospital, or you have to be contracted with managed care and get it at some kind of risk, because community-based palliative care is very difficult to make operate right now from a profitable [perspective].”

Specialization 93

Specialization Illness Healthcare Patient-Centered 93

GeriPal

JANUARY 12, 2023

Which patients are eligible to go to an ACE unit? So I picked the Ed Sheeran song, The A Team, because it reminds me of our ACE team that goes around the hospital and cares for our older patients. And a light bulb just went off in my head, like, yes, this makes sense as a model for how we should care for more complex older patients.

Hospital 101

Hospital Patient-Centered IT Nurse Practitioner 101

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 125

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. Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? How high is too high?

Diabetes 74

Diabetes Management Patient-Centered Families 74

The Medical Futurist

JUNE 21, 2025

Self-care and telemedicine for patients The options of teledermatology services, as well as self-care platforms, are soaring. It is a win-win for everyone: patients do not have to wait in crowded waiting rooms for an exam, while dermatologists can deal with the easier cases in shorter time online.

Patients 98

Patients Healthcare Board-Certified Telemedicine 98

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? The article we discuss today, also published in JAMA , addresses these two gaps. Big randomized control study that came out.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

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 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

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

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

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

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 IT Patients 116

GeriPal

OCTOBER 10, 2024

And it not only leads to better outcomes for patients, it leads to our better sustainability. In many settings, physicians have the ultimate legal and professional responsibility for overseeing patient care, which shapes physicians physician vision and expectations for collaboration, or lack thereof, of the core palliative care professions.

Screening 121

Screening IT Families Family 121

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

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?

Family 98

Family Families Patient-Centered IT 98

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.

Complication 52

Complication Patient-Centered IT Patients 52

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

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

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

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. Eric: Yeah.

IT 83

IT Families Family 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. 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

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

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

JUNE 5, 2025

Eric 03:25 So we have a lot to talk about, but I’m wondering if we can kind of take a big step back and just talk about the patient population that’s in nursing homes. Connie 06:18 So, I’ve been a clinician working in the nursing home since back in the 80s, and I saw a lot of patients that really needed palliative care.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

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

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. Healthcare staff were afraid of patients with HIV because there wasn’t clarity on how it was transmitted. It’s by choice, just like in the community.

Families 133

Families Family IT Community 133

GeriPal

APRIL 28, 2022

Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be. Nathan: I do.

IT 145

IT Hospital Patients Illness 145

GeriPal

MARCH 24, 2023

Usually I don’t put a lot of background on this podcast, but I got to … in November of 2022, Ava Kofman, along with ProPublica, published … well I won’t want to say great, published an article in The New Yorker that I think it was divisive in the hospice and palliative care community. Eric: Great. Now it’s 70%.

IT 115

IT Provider Patients Families 115

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. Kate 06:44 Patients were willing to complete advanced directive and picked the middle one.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. 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. Emily 06:27 Yes.

IT 108

IT Community Patients Families 108

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

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

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. 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