GeriPal

AUGUST 29, 2024

It feels nearly impossible if you add another degree of difficulty, whether it be a crying interpreter or a grandchild from another state who shows up at the end of a family meeting yelling how you are killing grandma. So the first thing, explain the diagnosis. And you’re in the ICU family meeting, and it gets heated.

IT 132

IT Illness Family Families 132

GeriPal

SEPTEMBER 28, 2023

First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Eric: Well, this is the part that I love about your article, too, is that it’s not just these big, big family meetings where miscommunication happens. Simple, right?

Family 144

Family Families Patient-Centered IT 144

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. And we got all into his family stuff and how he’d been suffering with cancer and his goal.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JULY 11, 2024

I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. And so I honestly think it has to do with how complex the diseases and the complications that come from it. Amy 12:23 I find this one. What’s the goal?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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

JUNE 9, 2022

By diagnosis? But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. Eric: Our outpatient service does have guides around diagnosis and prognosis.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

OCTOBER 12, 2023

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? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Family Families Patient-Centered 128

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

JUNE 15, 2023

Now actually suggesting perhaps that you missed a diagnosis that you should have considered? Eric: A lot of talk about the Aducanumab of the world, these amyloid antibodies diagnosing people with dementia really early on potentially for treatment, but also a diagnosis of dementia may limit people’s ability to do things like driving.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 16, 2022

We discuss with her how we should work-up and manage “urinary tract infections” (I’ve added air quotes to “UTI” in honor of Tom Finucane’s JAGS article titled “Urinary Tract Infection”—Requiem for a Heavyweight in which he advocated to put air quotes around the term UTI due to the ambiguity of the diagnosis.). Alex: This is Alex Smith.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices.

Family 106

Family Families IT Patients 106

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. 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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right. Jennifer: Oh nice.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. ” I think the family would like you to consider how to work with that. Jane: Right.

Provider 117

Provider Illness IT Healthcare 117

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? I wish they were just a diagnosis.

Patients 109

Patients IT Family Families 109

GeriPal

MAY 12, 2022

It’s easier to concentrate on cure, diagnosis, cure. The book starts with the story of your grandfather with whom you lived, and there’s obviously a lot of family connection that you talk about in your patients, but also for yourself. And then maybe like all low and middle income countries, the resources are limited.

Community 115

Community IT Relationship Healthcare 115

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. Eric: That’s a complicated form then. Karl: Okay. Karl: You can write it in.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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. Alex: Self-administer and psychiatric illness is not considered a qualifying diagnosis. So figured out a little harmonica- Eric: That was wonderful. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 3, 2025

Spoiler: It’s more complicated than it seems. And I was curious to learn about how people were talking about what to expect after a diagnosis of advanced cancer, how clinicians were counseling patients, how patients were understanding their prognosis and making decisions. Like at the time of diagnosis.

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52

GeriPal

SEPTEMBER 8, 2022

Holly has accumulated mountains of evidence for the diagnosis of prolonged grief disorder as a specific condition primarily notable for a yearning over a year after the death. It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Holly: Oh absolutely.

IT 100

IT Relationship Complication Specialization 100

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? But some of the nuance I would want to point out is that, like Brent mentioned, first of all, this is not a diagnosis. Like 80 to 90% of patients we see have a psychiatric diagnosis.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JULY 25, 2024

And so we know that the decision to enter a nursing home is incredibly challenging for families, especially because it often comes with thoughts that they’re, like, abandoning their loved one, really. So it’s not just like the patient or the family, but it’s also the healthcare system.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MAY 1, 2025

Alex 00:07 We are delighted to welcome Peter Selwyn, who is a family medicine and palliative medicine doctor and chairman of the Department of Family and Social Medicine and director of the Palliative Care Program at Montefiore E instein and author of Surviving the the Personal Journey of an AIDS Doctor. Is a new diagnosis of HIV.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. And I have a long interest in identifying family caregivers and supporting them in care delivery. And so this was really, in my view, a perfect window for reinforcing the role of family in primary care. Eric 02:32 Great, Alex.

Primary Care 79

Primary Care IT Clinic Illness 79

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. That this is iterative from diagnosis to end-of-life, right? Juliet: Sure.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

JUNE 6, 2024

So this is about two and a half, three years out from leukemia diagnosis. And the point of that is that so many people, in my experience, and I’m sure it’s the same initial diagnosis of cancer, that’s the last thing that I want to talk about. And I said, sure. And I had that mortified look on my face of God.

Illness 130

Illness IT Physicals Patients 130

GeriPal

AUGUST 22, 2024

I love these topics, too, because even how do we define what is a diagnosis? 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.

IT 113

IT Families Family Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

The pneumonia could get treated, but I think geriatricians, actually, were well aware of iatrogenic complications of care and quality gaps, even well before the IOM reports of the late 1990s and the like. In our larger studies, before the study that Tacara helped lead, we never required family members to be present, or do work.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JANUARY 5, 2023

And in these cases of obstetric complications with doctors literally not doing what was standard practice last month or before the ban, and not knowing whether they would be able to defend themselves for helping a woman come through a miscarriage by using Pitocin for example. You’re either giving that prescription or you are not.

Provider 19

Provider Medical Hospital Patient-Centered 19

GeriPal

JULY 16, 2024

Ken Covinsky reminds us that we should not be making a diagnosis based on what we see on TV, and that if a patient’s daughter expressed a concern that their parent “wasn’t right,” we would conduct an in depth evaluation that might last an hour. Cecilia Poon says, what are some best practices to highlight professional ethics?

Diagnosis 141

Diagnosis Diagnose IT Physicals 141