GeriPal

DECEMBER 2, 2022

Her most recent book is Dementia Friendly Communities: why we need them and how we can create them . She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. And that’s why we need this community support, I think. Transcript. This is Eric Widera.

Community 101

Community IT Individual Patient-Centered 101

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

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

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

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

My Green Doctor

JULY 2, 2025

in the need for healthcare—translating into over 500 million extra days of inpatient hospital care and more than 100 million emergency department visits across Europe by 2050. In the United States, extreme weather events and air pollution are already costing the healthcare system over $820 billion annually.

Healthcare 52

Healthcare Healthcare Professional Management Community 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. I would like to request the Friendship Train by Gladys Knight and the Pips.

Community 95

Community IT Patient-Centered Primary Care 95

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

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

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

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

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

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. So there’s an event or a series of events. Eric 04:19 Yeah.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

APRIL 3, 2025

So if you haven’t been to this event, there is a literature review where we. That was actually Ken, you remember that article, Nancy Schoenberg’s article on screening and what to say and what not to say to patients on how to talk. How to talk to patients about screening colonoscopies. Ken 09:56 We did a role play.

IT 64

IT Hospital Screening Patients 64

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. Thanks for having me.

IT 107

IT Community Patients Family 107

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.

Family 132

Family Families IT Community 132

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. Alex: And the Brigham and Women’s Hospital. Transcript.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. GeriPal podcast with Tom Gill on the Precipitating Events Study, distressing symptoms, disability, and hospice.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

FEBRUARY 17, 2022

I tell this story because these issues don’t typically register as more than a nuisance for clinicians, who frequently don’t understand why their older patient with osteoporosis is not taking a bisphosphonate. But our patients are walking with their feet, and adherence to bisphosphonates for osteoporosis is poor and decreases with time.

Clinic 67

Clinic IT Patients Medical 67

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

JUNE 13, 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.

Illness 133

Illness Patient-Centered Patients IT 133

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

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. 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. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. I think this is a really difficult topic to talk about with patients. She has a point. Prognosis is inherently uncertain.

IT 95

IT Clinic Screening Patients 95

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. Those disruptive events or shocks often portend a major decline in function from which people with dementia never fully recover. worsening prognosis.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

SEPTEMBER 12, 2024

Eric 04:44 Could just make you a little bit more resilient, you can increase your Rvus so you can see more patients. It’s really not about helping the patient or physician. So people are not so excited about this idea of resilience in the old fashioned way, this idea that it’s up to you. If you were just. Eric 17:16 Right.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

GeriPal

OCTOBER 3, 2024

Alex 00:08 UCSF’s Division of Palliative Medicine are looking to build on their research and clinical programs and are interviewing candidates for the associate chief of research position and for full time physician faculty to join them in the in-patient and out-patient settings. I wonder why you did that.

IT 122

IT Patient-Centered Patients Relationship 122

PEMBlog

APRIL 26, 2023

Kit Carney and Dr. Kristen Humphrey discuss gun violence, its impact on our patients and their families, as well as practical tips on advocating for safe storage of firearms, and how we can support victims of violence. When we protect our kids from the dangers of gun violence, the whole community stands to benefit. 2022, March 18).

Families 52

Families Family Mental Health Healthcare 52

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, welcome back to the GeriPal podcast.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

DECEMBER 7, 2023

Leslie Wharton is a leader in the 26,000 member grassroots organization Elders Climate Action , which organizes older adults to create communities engaged in making a difference at local, state, and national levels. And that’s a good thing to share with an older patient or client that making decisions about your activity.

Healthcare 129

Healthcare IT Education Hospital 129

GeriPal

JULY 6, 2023

Alex: We’ve got a lot to talk about…what states are doing and cities are doing to support older adults in the community. But, what you need is a community-based game there. Equally as important, is if you wind up in an ED or being hospitalized or wind up in rehab, eventually you’re going to be discharged back home.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. We would admit them to the hospital. Who doesn’t want to leave the hospital?

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Isn’t that what we always work with, with patients, with our colleagues, with ourselves? Can I ask, Redwing, do you ever ask patients or people you care for to write poetry? Alex: Mm-hmm (affirmative).

Patient-Centered 93

Patient-Centered IT Community Illness 93

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.

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. So people are less able to have the language when the loss event actually happens. Turns out, it’s maybe not. And we don’t talk about it as much.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

Pamela Wible MD

JUNE 19, 2025

In order to heal her patients she first had to heal her ailing profession. Fed up with assembly-line medicine Dr. Wible held town hall meetings and she invited citizens in her community to design their own ideal clinic. Open since 2005 her community clinic has inspired Americans to create ideal hospitals and clinics nationwide.

Clinic 246

Clinic Nurse Practitioner IT Medical 246