GeriPal

JUNE 20, 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 121

IT Patient-Centered Patients Clinic 121

GeriPal

JANUARY 12, 2023

Which patients are eligible to go to an ACE unit? So I picked the Ed Sheeran song, The A Team, because it reminds me of our ACE team that goes around the hospital and cares for our older patients. And a light bulb just went off in my head, like, yes, this makes sense as a model for how we should care for more complex older patients.

Hospital 101

Hospital Patient-Centered IT Nurse Practitioner 101

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 we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 74

Diabetes Management Patient-Centered Family 74

GeriPal

MAY 11, 2023

Certainly education, quality of education is extremely important. Some of them, like education, definitely social determinants of health. Like, education, is it that it prevents you from getting Alzheimer’s disease, or does it just give you more reserve so Alzheimer’s peeks out later?

Physicals 86

Physicals IT Hypertension Education 86

GeriPal

JUNE 12, 2025

Summary Transcript CME Summary If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. Anish 01:02 Well, I speak, you know, from a physician lens of some of the patients that I get referred, and by the time there’s. This is not a good option.

Patient-Centered 103

Patient-Centered Referral Patients IT 103

GeriPal

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. Your research is a lot in this patient population, right? It used to be a much more complicated model. However, its main predictors are age, comorbidity, and healthcare utilization. Lyndsay: Yes.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then one patient who really knew more about a topic than I did, which unfortunately happens much more often.

Medical 100

Medical IT Patient-Centered Healthcare 100

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. They were stunned by the number of calls for lift assistance for older adults who had fallen. Carmen: Yeah.

Community 116

Community Transportation IT PCP 116

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. Kirsten 04:16 So, in emergency medicine, obviously, we are interacting and caring for these both exciting and interesting, but also very complex and humbling patients to care for in the ED setting. AMA PRA Category 1 credit(s) ™.

Patient-Centered 110

Patient-Centered IT Patients Clinic 110

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? Something I’ll often point out to patients is, you know, how do you identify your emotions? On today’s podcast, we’ve invited Alex Gamble and Brianna Williamson to talk to us about anxiety.

Illness 130

Illness IT Diagnosis Patient-Centered 130

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 98

IT Patient-Centered Patients Board-Certified 98

GeriPal

AUGUST 29, 2024

During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Why did you all decide to write an updated book on navigating communication with serious ill patients? Gordon 02:02 I do.

IT 133

IT Illness Family Families 133

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? 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 52

Complication Patient-Centered IT Patients 52

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 133

Patient-Centered Hospital Patients IT 133

GeriPal

JULY 21, 2022

Initially, it was just because there weren’t really answers for my patients. If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. We’re going to go into how to talk to patients about this, because Emmy, you’ve done some research on it.

Family 102

Family IT Families Diagnosis 102

GeriPal

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. William: Thanks so much.

Patient-Centered 130

Patient-Centered IT Patients Clinic 130

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. Are we seeing people like more older adults, more nursing home patients starting dialysis, and even at a higher gfr? So I wonder if I could turn to either of our nephrologists.

Management 117

Management Patient-Centered Patients IT 117

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” Lynn: I do. Alex, can you play Send the Sun, by Nikki Lane?

Family 98

Family Families Patient-Centered IT 98

GeriPal

NOVEMBER 21, 2024

Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. You probably haven’t read in a while what that patient encounter was like. Coping is something that we see our patients do. We can ask ourselves, is it serving the patient? How is it serving the patient?

Illness 126

Illness IT Patient-Centered Patients 126

GeriPal

MARCH 9, 2023

Early data on efficacy in patients with anxiety and demoralization are promising. Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). Research is exploding. You’ve been trained?

Patient-Centered 91

Patient-Centered Community IT Medical 91

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. Patient Values: Three Important Questions-Tell me more? Simple, right? Not so much, as each one of these steps is fraught with miscommunication. What else?

Family 144

Family Families Patient-Centered IT 144

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. I did it before and this guy, he was 85, but he was climbing Mount Everest.”

IT 129

IT Family Families Patient-Centered 129

GeriPal

SEPTEMBER 5, 2024

And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics. The patient case. Alex 15:13 This is really complicated. Alex 03:33 Yeah.

Patients 98

Patients IT Patient-Centered Hospital 98

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 Family Families Physicals 137

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. It can influence education systems. It can influence a whole bunch of things and have deleterious effects.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. There was no conversation with the patient or the family about this. We talk about challenges facing the field today. And the focus was on their comfort.

Illness 110

Illness IT Family Families 110

GeriPal

MARCH 28, 2024

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. And that’s it. Kate: Sure.

Consulting 116

Consulting Patient-Centered IT Patients 116

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 134

Illness Patient-Centered Patients IT 134

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. Clinicians were randomized to 4 groups: Usual care Prognosis nudge – EHR prompt asking, do you think your patient will be alive in 6 months?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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. Rebecca: I think I’ll also add too.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

JULY 28, 2022

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. Eric: And what a research agenda that you’ve done, including one of the most seminal papers that we have in palliative care in lung cancer patients.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

MAY 26, 2022

Govind: So even if there’s some reason to worry about considering vaccination status, on the one hand, maybe disadvantage some unvaccinated COVID patients who might disproportionately suffer certain kinds of disadvantage, in scarcity you have to think, well, what’s the alternative?

Vaccination 88

Vaccination Individual IT Healthcare 88

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. A NY Times article titled Should Patients Be Allowed to Die From Anorexia ? We don’t have a way of operationalizing which patients qualify.

Illness 102

Illness Mental Health IT Patient-Centered 102

GeriPal

NOVEMBER 17, 2022

The songs about how saving lives is actually a pretty complicated business. And she had started this practice following her mental health patients as they got older, and invariably over decades of her practice, her practice became an assisted living practice, because all of her patients ended up moving into assisted facilities.

Community 97

Community IT Mental Health Medical 97

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. 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.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 13, 2025

How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? And so it was really the patients, you know, the caregivers, the family members were the ones who were sort of the closest in observing. Who would/should be on that board?

Consulting 64

Consulting Community Patient-Centered Family 64