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. I was really passionate about helping the people and also their families. David: Right. Eric: Okay.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

OCTOBER 12, 2023

And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications? Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis?

IT 128

IT Family Families Patient-Centered 128

GeriPal

JUNE 9, 2022

But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training. And I practiced both on the palliative care consult team and in the ICU.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? 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 falls and breaks her hip. She has advance dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. 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.

IT 83

IT Family Families Illness 83

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?

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. 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. Is that your feeling, too? Eric 45:24 Yeah.

Medical 98

Medical IT Patient-Centered Healthcare 98

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

NOVEMBER 21, 2024

But if we’re going to have a family meeting, that’s a different circumstance. It’s amazing how often when we’re taking care of somebody in the hospital, if you have Say, you know, a family member who is not showing up for visits with the medical team or who is. So help serves and hinders in everybody.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

JUNE 15, 2023

So there’s some stuff out there like that, but also using AI to determine who at high risk and should get a palliative care consult. And then when we started coming up with mortality models or other sorts of prediction models with five factors or seven factors, people were like, “That’s too complicated. Eric: Really?

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

FEBRUARY 13, 2025

You did a rural tele-palliative care consultation study. And so the video consult was what became the mode. Marie 03:42 So probably the most important thing is we developed the consultation as a culturally based consultation process. And then we incorporated that information into the consultation process.

Consulting 63

Consulting Community Patient-Centered Family 63

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. Is that right too?

Hospital 125

Hospital IT Patient-Centered Patients 125

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. And so we simply asked clinicians, have you offered this patient and, or their family the option of care focused on comfort? What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

FEBRUARY 15, 2024

Eric: Well, what are the odds that two family members focus on a similar topic and do research together? laughter] Alex: We love the family theme. The post EMS Intervention to Reduce Falls: Carmen Quatman and Katie Quatman-Yates appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional.

Community 114

Community Transportation IT PCP 114

GeriPal

FEBRUARY 16, 2023

So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond. What feelings do we have toward the patient and toward their families? And countertransference is everywhere.

Patients 109

Patients IT Family Families 109

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. And it’s very traumatic obviously for the family and all of that and the team really. Yeah, that’s a more complicated story.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

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. John: I am what I am, which is a family practice doctor. Eric: When I try to think about what a doula does, should I call it a consult? It just depends.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MAY 12, 2022

When we think about palliative care delivered here, like individuals with chronic pain, non-serious illness chronic pain, non-life threatening illness, oftentimes if we get consulted on them, we don’t even see them, may just be discontinued in most palliative care places. What do you think about that?

Community 115

Community IT Relationship Healthcare 115

GeriPal

MARCH 6, 2025

Michael’s Hospital in the Department of Family and Community Medicine. And this is really traumatic event for his street family and the street community that he knew. 80% died exactly where they wanted to and 83% were reconnected to family or friends through a psychosocial support system that we put into place.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

JANUARY 11, 2024

So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. The first one is I would want the general public and healthcare professionals to really understand actually what natural dying and death look like.

Illness 144

Illness IT Medical Provider 144

GeriPal

DECEMBER 19, 2024

So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families? Eric 12:11 And we consult psychiatry. And I’ll say we were clinically at the VA doing inpatient palliative care consults. We do not have a psychiatrist, but we have consultants.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JULY 3, 2025

Spoiler: It’s more complicated than it seems. 09:04 And I think that’s where the irony came from as well, because of the not only confusion within our field, but the confusion of patients and families who are the consumers of palliative care and the referral sources. Their family may be impacted, they may have social pain.

Patient-Centered 52

Patient-Centered Illness Clinic IT 52

GeriPal

SEPTEMBER 5, 2024

Alex 15:13 This is really complicated. She entertained her family. Thanksgiving’s coming up, you’re having your family, Christmas coming up. You’re going to go traveling to Hawaii with your family, and, you know, you want to die in January. This shouldn’t have happened. We can make this better.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. We started a clinic here in 2008 at the VA, and what we found was that, you know, our median time from consult to death before we started clinic was like 18 days, somewhere around there, like somewhere around two weeks. Eric 10:44 No, all consults.

Family 106

Family Families Patient-Centered Patients 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

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. And I think the advanced planning debate is really a question of, how do we help this very complicated situation? It’s hard for your family to know. It’s part of our family mythology. We see them struggle, right?

Illness 98

Illness Patient-Centered IT Family 98

GeriPal

AUGUST 22, 2024

Patients families want to know whether their loved one has died. And one would be when care is continuing a case where people believe that the patients died, or oftentimes, this is also a source of controversy between families and clinicians. And I think maybe we could list them all. That’s one key interested party.

IT 113

IT Family Families Patient-Centered 113