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? I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Guests Alex Gamble and Brianna Williamson have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

NOVEMBER 21, 2024

We are going to tackle this question and so many more about coping on this week’s podcast with Dani Chammas , a recurring GeriPal guest, psychiatrist, and palliative care doc at UCSF, and Amanda Moment , a Palliative Care Social Worker at Brigham and Women’s Cancer Center. Coping in the setting of serious illness.

Illness 125

Illness IT Patient-Centered Patients 125

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.

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. But the patient would say, well, but it still hurts, though.

Illness 133

Illness Patient-Centered Patients IT 133

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

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

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 109

Patient-Centered IT Patients Clinic 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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

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

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 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers.

Illness 110

Illness Hospital Patient-Centered Patients 110

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

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. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center.

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

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. – Serious Illness Conversation Guide podcast. There was no conversation with the patient or the family about this. AlexSmithMD . Transcript.

Illness 109

Illness IT Family Families 109

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 99

Medical IT Patient-Centered Healthcare 99

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

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 116

Management Patient-Centered Patients IT 116

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. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades. Alex: Thank you.

Illness 144

Illness IT Medical Provider 144

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

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 128

IT Family Families Patient-Centered 128

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. I’ve had a patient in one room, they have stage four breast cancer. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study.

IT 137

IT Family Families Physicals 137

GeriPal

MARCH 28, 2024

And we have Kate Courtright, who’s at University of Pennsylvania, the PAIR Center. 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. Kate: These are very sick patients. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

NOVEMBER 17, 2022

staff training in person centered care). The songs about how saving lives is actually a pretty complicated business. And that’s the complication here is there’s so many things that the staff can be trained on. Staff training on person-centered care. toenail trimming) to things in between (e.g. Alex: Yeah.

Community 97

Community IT Mental Health Medical 97

GeriPal

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. But in the end, I see these as my patients and I’m trying to define what is the right model. My wife is also a physician and she said he’s dying.

Provider 117

Provider Illness IT Healthcare 117

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? I’m Marie Bakitas, and I’m a professor at the University of Alabama at Birmingham and also the associate Director of the center for Palliative and Supportive Care.

Consulting 63

Consulting Community Patient-Centered Family 63

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

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. And he’s also chaired the California Pacific Medical Center’s ethics committee since 1985.

Patients 98

Patients IT Patient-Centered Hospital 98

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. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. Get to learn some Spanish for this one.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

AUGUST 22, 2024

Patients families want to know whether their loved one has died. Doctors want to know whether the patient has died. And one of the principal driving factors behind doctors wanting to know whether the patient has died, I think we need to acknowledge, is harvesting organs for transplant. This patient died.

IT 113

IT Family Families Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115