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. What are the risks and rewards of new classes of medications? When I’m on nursing home call, the most common page I receive is for a blood sugar value. How high is too high?

Diabetes 74

Diabetes Management Patient-Centered Families 74

PEMBlog

OCTOBER 2, 2024

uh, ill defined epigastric or chest pain, and it’s often worse by eating or lying down after meals. In rare, severe cases where GERD is refractory to medical management, surgical interventions like fundoplication may be considered, especially in kids with neurologic impairments or life threatening aspiration.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

JUNE 27, 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 129

Illness IT Diagnosis Patient-Centered 129

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?). I was really fascinated not only with the medical side of things, but some of the. So I think education is key. Anish 04:13 Yeah. Thank you.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. David is a physician who wrote the book “ Stoned: A Doctor’s Case for Medical Marijuana ” and gave a TED talk on “ A Doctor’s Case for Medical Marijuana ” that was watched over 3 million times. Eloise, welcome to the GeriPal podcast. Eric 01:34 Yeah.

Medical 99

Medical IT Patient-Centered Healthcare 99

GeriPal

NOVEMBER 21, 2024

Coping in the setting of serious illness. Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. And so I let him educate me. Here are some more resources we’ve discussed in the podcast Dani’s NEJM article on coping: “ Should I Laugh at That? Should I laugh at that?

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. David: Thank you.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. When people have no appetite, they know they’re ill. Yeah, yeah, exactly.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

MARCH 9, 2023

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). And some people in studies and just in clinical use have found that to be helpful, including for patients with serious illness.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today. Eric 05:03 Nice.

IT 132

IT Illness Families Family 132

GeriPal

AUGUST 11, 2022

– Serious Illness Conversation Guide podcast. He’s assistant professor of medicine at UCSF, and he’s one of my former research mentees, and he’s very interested in medical ethics and decision making in the ICU. I was a medical and psychiatric resident between 1977 and 1982. AlexSmithMD . Transcript.

Illness 109

Illness IT Families Family 109

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. And so I knew that I wanted to do something related to palliative care because I work with people with advanced and serious illness.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JANUARY 11, 2024

Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. Four percent. This is Eric Widera.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 23, 2023

Emily is a bioethicist in the Department of Medical Ethics and Health Policy at the University of Pennsylvania. And as we all know, for many people there comes a time where they are no longer able to make their own medical decisions. And I know we’re talking a lot about medical decision making. Eric: Lynn or Anne?

Families 98

Families Family Patient-Centered IT 98

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

OCTOBER 20, 2022

Alex: And we are also delighted to welcome Devika Nair, who is a nephrologist at Vanderbilt University Medical Center in Tennessee Valley VA Healthcare System. That includes many medical specialists, surgical specialists, many specialists and many other disciplines who are on our older adults team. Rasheeda, welcome to GeriPal.

Complication 52

Complication Patient-Centered 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

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. Areej: So when I was in college, I had a close friend who had a serious illness and actually died as a result of cancer. And so I went into medical school wanting to cure cancer. Additional links: Editorial on Areej’s study. Transcript.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

NOVEMBER 17, 2022

The songs about how saving lives is actually a pretty complicated business. You’re independent, drive in and out, and the more help you need, so for example, now you need somebody to help with medication administration. But why I decided to look at medical and mental health care and assisted living. Alex: Yeah. Eric: Nice.

Community 97

Community IT Mental Health Medical 97

GeriPal

SEPTEMBER 28, 2023

Summary Transcript Summary Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. A “Three-Stage Protocol” for Serious Illness Conversations: Reframing Communication in Real Time Transcript Eric: Welcome to the GeriPal podcast. Simple, right?

Families 144

Families Family Patient-Centered IT 144

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. Eric: Well, Terri and Emmy, thank you for joining on this podcast. How did you both get interested in this as a topic? They’re really not.

Families 102

Families IT Family Diagnosis 102

GeriPal

NOVEMBER 7, 2024

We also briefly mention Susan Wong’s terrific studies that found a disconnect between older adults with renal failure’s expressed values, focused on comfort, and their advance care planning and end-of-life care received, which focused on life extension; and another study that found quality of life was sustained until late in the illness course.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MARCH 7, 2024

He looked very ill. An end-of-life doula is a non-medical support person that provides a longitudinal relationship with aspects of medical, I mean, aspects of companionship, presence, holding space, some logistics, some practical help, decision making perhaps. My wife is also a physician and she said he’s dying.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. You can hear Tyler and I having a great time singing together and sharing stories around his podcast My Medical Mixtape. And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ?

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. ” BJ: Well, I fall back on using physiology in the sort of medical sense. laughter] Eric: And part of that is this idea of, in hospice, sometimes we just try to medicate suffering away. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. 2023.11.004.

IT 137

IT Families Family Physicals 137

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

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? Alex: And we’re delighted to welcome Justin Clapp, who is assistant professor of anesthesia and critical care and medical ethics and health policy. Gretchen: Thank you.

IT 128

IT Families Family Patient-Centered 128

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 77

Patient-Centered IT Hospital Patients 77

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. They wanted you to be respectful of their cultural beliefs and their, you know, faith beliefs that were driving their health and illness. Marie 11:03 Yes.

Consulting 63

Consulting Community Patient-Centered Families 63

GeriPal

MARCH 28, 2024

Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. Kate: Yeah, some of the thoughts I’ve had in thinking about this: we did not require communication, training and education of the clinicians. Alex: We had you on just recently, the podcast. Kate: Sounds right. Eric: Okay.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

SEPTEMBER 5, 2024

And he’s also chaired the California Pacific Medical Center’s ethics committee since 1985. You know, she would have had 90 really good years, and she would have just gone into a coma with no blood pressure and died, you know, with, like, a day and a half of illness. Alex 15:13 This is really complicated.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

JUNE 6, 2024

Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. So we got a lot to cover on sexuality, sexual health, and serious illness. And that really is what prompted me to get certified as a sexual education provider. Don, welcome to GeriPal. Don 01:11 Thank you so much. The state of the science.

Illness 130

Illness IT Physicals Patients 130

GeriPal

MARCH 27, 2025

Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. 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. Alex (singing) Alex 02:34 All right, this was a fun one.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

MAY 1, 2025

And I graduated from medical school in the early 80s. And I was working at the time at Yale in New Haven, and I became medical director of a facility which was initially created in New Haven as a hospice like facility for people with HIV, which is in late 1995 and in 1996 when the Protease inhibitors came along. Meredith 09:33 Yes.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

AUGUST 22, 2024

Alex 28:22 That’s not in the vital talk, serious illness, communication. And for all the ways in which every single case of brain death is so complicated, you might step back and say that brain death is working out okay in the real world, right? There’s disagreement within, some medical associations are against this.

IT 113

IT Families Family Patient-Centered 113