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. And I can only imagine that’s even more complicated in the cancer patient population, where we’re asking them to do so many other things as well.

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

JUNE 12, 2025

So you have the consultation. But two, a very close relationship with potentially the palliative care physician or the individual who’s Sort of managing their pain, because the simulation itself can be 20 to 30 minutes of lying in that specific treatment position. But the process and procedure for radiation is like a process map.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Rao Doctor

APRIL 3, 2025

While mild fevers often resolve on their own, persistent or severe fevers warrant professional evaluation. Fever in infants under three months, a fever lasting more than three days, or a fever in individuals with weakened immune systems should be promptly addressed by a doctor for appropriate management and treatment.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. Infections or allergic reactions can block your airway and lead to life-threatening complications.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JANUARY 25, 2024

It used to be a much more complicated model. However, its main predictors are age, comorbidity, and healthcare utilization. As a nurse, how challenging would it be to do eight hours of training and jump into this complicated world? So, the docs actually wrote orders for tests, medications, consults. David: Right.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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 Patients IT 115

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. You have a patient with dementia severe enough that she cannot recognize relatives.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JUNE 9, 2022

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. I have never myself called a palliative care consult as a trainee because we didn’t have one. And I practiced both on the palliative care consult team and in the ICU.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. I mean, how do you negotiate that with the oncologist who is the one who consulted you, by the way, Eric, who does that go to? This is a complicated case.

IT 132

IT Illness Families Family 132

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is Eric Widera.

Family 97

Family Families Patient-Centered IT 97

GeriPal

FEBRUARY 15, 2024

But that was a small pot of money and we went to first call a handy person, it was going to be $500 for a consultation, let alone the installation, and we were like, “This is absolutely cost-prohibitive. All of these are factors that are on the individual level. We’ll get four people done.”

Community 114

Community Transportation IT PCP 114

GeriPal

MAY 4, 2023

Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. The whole idea of holding hope seems also so much more complicated for younger people because the hopes that they had, the normal hopes are not likely to be realized. Eric: Yeah. What are the patients that we remember?

Families 83

Families Family IT Illness 83

GeriPal

OCTOBER 26, 2023

In recent years, pressures to decrease hospital length of stay and increase throughput, the rate at which patients are moved in and out of the system has contributed to a culture in many acute care environments where physical therapy functions primarily as a consultation service for discharge planning. Ann: My palliative care doc is great.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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 Families 63

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. We tested two different nudges individually and then we combined them. What is sludge? I highly encourage you. Kate 13:59 What did we do?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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. Yeah, that’s a more complicated story. But yeah, it’s complicated. So that’s great. And it was like 29eds. Yeah, yeah.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. We talk a lot about people being unhoused, which I think takes the blame away from the individual and kind of de. Naheed 20:04 And you know, the key to this conversation is not to put the onus on individuals.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

DECEMBER 14, 2023

And so the combination of the institutional structures, as well as the extreme cases that each individual doctor feels will actually help create this different culture, be it high or low intensity. It’s not explainable that each individual physician has independently arrived at this very aggressive practice pattern.

Hospital 125

Hospital IT Patient-Centered Patients 125

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. So it started off for individuals with a terminal illness. And making most I can do, I can use my mouth even though I only have six fingers here.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 7, 2024

It sets space between us and the individuals we’re trying to take care of. I thought that was an interesting take on doing this, because a mother-daughter relationship can be complicated, can be wonderful, and it’s hard to navigate when you lose your mother. I often say that doulas are mirrors. 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

DECEMBER 19, 2024

So we’re going to be talking about palliative care for individuals with mental illness. Eric 12:11 And we consult psychiatry. Depending on your geography, who you are as an individual, the ethical parameter you’re considering. And I’ll say we were clinically at the VA doing inpatient palliative care consults.

Illness 101

Illness Mental Health IT Patient-Centered 101

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.

Families 106

Families Family Patient-Centered Patients 106