GeriPal

JUNE 8, 2023

-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JUNE 12, 2025

During my training, I didn’t receive much education about radiation oncology, and I’m not entirely sure what some of the terms mean (hypofractionated means fewer sessions, right?). Anish 07:54 I would say sort of echoing what Emily was just referring to is education is key. So I think education is key.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 15, 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.

Community 114

Community Transportation IT PCP 114

GeriPal

JULY 21, 2022

If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. But I think then the other factor in this that makes it complicated is the decision for someone in Manhattan might be very different than the decision for someone in, like, rural Wyoming. Alex: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

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.

Patient-Centered 52

Patient-Centered Complication IT Patients 52

GeriPal

JULY 11, 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.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JANUARY 25, 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.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. It’s baked into people’s belief systems, who ultimately make laws and make policies, and it can influence healthcare. It can influence education systems.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

OCTOBER 26, 2023

It’s very challenging from a hospitalist standpoint because I think there’s definitely a population of people who are not educated well about what are the outcomes when people go to subacute rehab, who benefits from that. We provide critical education. Sarguni: I hear what you’re saying and I struggle.

Patient-Centered 132

Patient-Centered Hospital Patients IT 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. Not anymore.”

Family 97

Family Families Patient-Centered IT 97

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. We’ve done work with medical improvised, we’ve done work in museum based education. This is a complicated case. Eric 40:08 Great.

IT 132

IT Illness Families Family 132

GeriPal

MARCH 9, 2023

Alex: It’s complicated. We, for very complicated reasons, ended up with niacin. I’ve met individuals in, let’s say indigenous communities and Columbia, they have longstanding uses of psychedelic plants and some of them are not interested in outsiders learning these ways and having access to these substances.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

FEBRUARY 8, 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.

IT 137

IT Families Family Physicals 137

GeriPal

MARCH 24, 2022

Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. So it’s an example of something that can start outside of the healthcare system and move its way in. And the reality is they don’t.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

MAY 15, 2025

We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. We tested two different nudges individually and then we combined them. And especially that requires a lot of education.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

APRIL 10, 2025

Yeah, that’s a more complicated story. But yeah, it’s complicated. The one thing that we know is that education alone will not actually deliver behavior change. You’d have to tailor it to each individual emergency department because you couldn’t. And it was like 29eds. Is that right? Yeah, yeah.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

NOVEMBER 7, 2024

Or is it just this lingering practice of starting dialysis early before really severe complications develop? So we created these heat maps where you could see for each individual what actually happened in the days and you. Alex 06:10 Or having watched that John Oliver episode about DaVita, we will have a link. And we have these.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MARCH 6, 2025

Just out of fellowship, Naheed built a palliative care program for homeless persons called the Palliative Education and Care for the Homeless (PEACH) Program. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Today we discuss: What is the best terminology?

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

JANUARY 11, 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 144

Illness IT Medical Provider 144

GeriPal

MARCH 28, 2024

Kate: Yeah, some of the thoughts I’ve had in thinking about this: we did not require communication, training and education of the clinicians. Eric: I think about it as the first one to address individuals’ curative therapy. It’s complicated because right now there’s no mechanism other than cost avoidance.

Consulting 115

Consulting Patient-Centered IT Patients 115

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. Again, I go back to this.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. So we’re going to be talking about palliative care for individuals with mental illness. And so why are we not educating psychiatrists and palliative care.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

MAY 29, 2025

Andrew complicates this definition , stating it raises more questions than answers. So I think the examples that we’ve seen is an individual will all of a sudden start using humor in a particular way or will using wry humor and that is reminiscent of the kind of humor the person used prior to developing dementia. And the Clin.

Family 93

Family Families IT Patient-Centered 93

GeriPal

FEBRUARY 13, 2025

And so we worked closely with a community advisory group who, through focus groups, told us how it was that black and white individuals with serious illness had wanted to be treated. The black individuals wanted to have a separate one from the white individuals. So absolutely, it is complicated. Our consultation.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

JULY 28, 2022

And so when we’ve tried to scale and implement the early palliative care model to other institutions, that’s the area where we’ve had to do a lot of teaching, mentoring, and education with palliative care clinicians, because for many of them, it is a brand new skill. Jennifer: I think it’s such a complicated question.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JULY 25, 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.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

But the process of implementing this project across two big health systems in our area was very complicated and had its share of both challenges and rewards. There’s also education that goes with it, educating, like, what does that mean? And is it at all individualized to the patient? It’s a lot. Yeah, yeah.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

MAY 1, 2025

But the HIV we do see, and it feels tragic because the people who are dying of and affected by the more kind of traditional, if you call it that, kinds of complications, some of which can be fatal of HIV AIDS are the people who are not on treatment. Older adults may not have received AIDS education. Meredith 17:07 Yes.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JANUARY 5, 2023

And the argument was framed more as a healthcare choice made by individuals in conjunction with their clinicians. By way of… Sort of starting this off, it’d be great if one of you would come up and help educate our audience in some lay terms, what are rights of consciousness? So religion, much less.

Provider 19

Provider Medical Hospital Patient-Centered 19

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. And then, it did, finally, come to an end, but the hospital-at-home community was able to educate policymakers.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 16, 2024

I think what ageism, when you get right down to it, is, is not really seeing the individual in front of you and the individual in the setting of what they’re trying to accomplish and what matters to them, that it’s always appropriate. Eric 04:17 How do you think about that? There is a tension. So can I ask a question?

Diagnosis 141

Diagnosis IT Diagnose Physicals 141