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. What is the role of the family caregiver system, how they play a role?

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GeriPal

JULY 19, 2024

Alex 00:20 And she’s professor of family medicine at USC, deputator at JAGS, and co lead of the bold center of Excellence in early detection of dementia. Well, because they’re hard on people with dementia and they can be very hard on families, and they’re a form of crisis. Is that right, Soo? Soo 00:32 Thanks.

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Screening Primary Care Patient-Centered IT 119

33 Charts

OCTOBER 2, 2021

Why MyChart messages create a challenge for hospital systems So more contact and connection between doctors and patients seems like a good thing, right? Some of these Epic features can create the expectation of concierge-level service — a challenge at a time when hospitals are facing a global pandemic with crisis-level staffing.

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PEMBlog

JULY 17, 2023

It is important that families replace the G-tube or use a foley within 4 hours to help maintain patency of the stoma as the stoma can close quickly. At that point you can follow the step of inserting new G-tube Bonus Videos This video is by Nemours Children’s Hospital. What is the size in diameter (French) and length of the G-tube.

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Mere Mortal MD

MAY 22, 2025

People are not usually fond of hospitals, especially if they happen to be the patient. A hospital is a place for sick people, a place where death lurks around the corner, where a blood sucking phlebotomist pokes around your veins after strapping a blue rubber band tightly around your upper arm. Thanks for reading Mere Mortal MD!

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StorytellERdoc

MARCH 18, 2020

Gone are the carefree smiles, the uncomplicated daily lives, and the thought that we and our families are immune to unexpected death. Friends and family have asked me my thoughts on Covid-19, maybe believing I have some special information simply from being on the front lines. We are all scared.

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GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

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GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. Should you stop at “no?” We will have to reach out to your daughter then to help with decisions.

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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. And you’re in the ICU family meeting, and it gets heated. So it’s a lot, but it’s good.

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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?

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Vida Family Medicine

MARCH 28, 2024

As a primary care physician, I am asked about these medications at least once a day, either by a patient, a colleague, a family member, friend, or acquaintance. Diabetes, cardiovascular disease, and metabolic associated fatty liver disease all have the potential to cause life-altering complications and premature death.

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Diabetes Primary Care Physician Medical Patients 52

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

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GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. I was really passionate about helping the people and also their families. David: Right.

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GeriPal

JULY 11, 2024

So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. And it’s usually those people that I’m seeing.

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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? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. She falls and breaks her hip.

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Patient-Centered Complication Patients IT 101

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience.

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GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Family member, and with some chagrin- Eric: Powerful nudge. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3.

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GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable.

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Physician's Weekly

JUNE 23, 2025

She called the NIH news “a complicated mix of emotions,” CNN said. “We These funds would be a lifeline for many families who are still grappling with health concerns and some economic hardship,” she said. But experts say it can be hard to link cancers directly to the chemicals from the crash.

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GeriPal

FEBRUARY 15, 2024

Eric: Well, what are the odds that two family members focus on a similar topic and do research together? laughter] Alex: We love the family theme. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Welcome, Katie, to the GeriPal podcast. Katie: Awesome.

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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? What I need to navigate with that patient and their family, is it valuable to you? And when they talk to patients and families, it’s a pretty easy sell. Every time.

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IT Family Families Patient-Centered 128

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 I started my career at Barnes-Jewish Hospital in St. But rarely does the podcast and clinical reality meet in the same day.

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Patient-Centered Hospital Patients IT 132

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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay. What is sludge?

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Patient-Centered Hospital IT Illness 116

GeriPal

NOVEMBER 21, 2024

Alex 00:26 And we’re delayed to welcome Amanda Moment, who is a palliative care social worker at the Brigham and Women’s Hospital in Boston. But if we’re going to have a family meeting, that’s a different circumstance. What are you seeing in terms of the relationship between this patient and their family?

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Illness IT Patient-Centered Patients 125

GeriPal

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. .

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Illness IT Family Families 109

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. This is my early father’s day gift from the family. Welcome to the GeriPal podcast, Jennifer. Jennifer: Thanks. Welcome to the GeriPal Podcast, Areej. Eric: Yeah.

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Illness Hospital Patient-Centered Patients 110

GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

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Patient-Centered IT Patients Clinic 129

GeriPal

MARCH 24, 2022

And especially for those who may have nontraditional families. I think if you’re from a nontraditional family, it’s very important to make sure that people understand who you would want to talk to. Assigning a surrogate decision maker is important for everyone, including those who do don’t have a serious illness.

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Illness IT Healthcare Patient-Centered 72

GeriPal

AUGUST 25, 2022

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. It’s really a pretty traumatic experience for a lot of patients and families. And I had a blast playing Take the Money and Run!

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Family Families IT Patients 106

GeriPal

NOVEMBER 14, 2024

And the big things that we think about as far as complications, so there, obviously the thing that comes to everybody’s mind is like fractures. Like there’s nothing we can do or do you feel like and we can talk about if so there are things that we can do to prevent falls and prevent the complications of those falls.

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IT Screening Patient-Centered Community 124

GeriPal

MAY 29, 2025

Today we talk about lucid episodes and what they might mean to the person with dementia, their family and loved ones, to philosophers, to clinicians, to neuroscientists. Andrew complicates this definition , stating it raises more questions than answers. Particularly patients, families. That their loved one is in there.

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Family Families IT Patient-Centered 93

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. And my community and about my family and those kinds of things. Our consultation.

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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? And countertransference is everywhere.

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GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

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Patient-Centered IT Patients Illness 126

GeriPal

JULY 3, 2025

Spoiler: It’s more complicated than it seems. We’ve invited two palliative care doctors to talk about survivorship with us: Laura Petrillo , a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker , an outpatient palliative care doctor at the Cleveland Clinic. 00:34 Thrilled to be here.

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GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. It’s what I know.

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Family Medicine Initiative

APRIL 10, 2024

Family medicine is neither the most prestigious nor the highest paid medical profession. GPs Are the Backbone of Effective Healthcare Systems Countries with a stronger focus on primary care and family medicine, rather than on hospitals and specialists, enjoy better health, 1 , 2 lower health inequalities, 2 , 3 and prevent hospitalizations.

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