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.

Community 114

Community Transportation IT PCP 114

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?

Family 144

Family Families Patient-Centered IT 144

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.

Patient-Centered 101

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.

IT 96

IT Patient-Centered Patients Board-Certified 96

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.

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

Patient-Centered 132

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?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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.

IT 124

IT Screening Patient-Centered Community 124

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.

Illness 110

Illness Hospital Patient-Centered Patients 110

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.

IT 128

IT Family Families Patient-Centered 128

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. .

Illness 109

Illness IT Family Families 109

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.

IT 83

IT Family Families Illness 83

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.

IT 137

IT Family Families Physicals 137

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?

Illness 125

Illness IT Patient-Centered Patients 125

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. So it’s an example of something that can start outside of the healthcare system and move its way in.

Illness 72

Illness IT Healthcare Patient-Centered 72

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.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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.

Patient-Centered 55

Patient-Centered Illness Clinic IT 55

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!

Family 106

Family Families IT Patients 106

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!

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. And it’s very traumatic obviously for the family and all of that and the team really.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

NOVEMBER 17, 2022

The songs about how saving lives is actually a pretty complicated business. I mean, people who used to be in hospitals are now with quicker DRGs. And that’s the complication here is there’s so many things that the staff can be trained on. Others take care of people less so, a more hospitality model, if you will.

Community 97

Community IT Mental Health Medical 97

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. Later on, of course, we added health professionals to, you know, give us more information.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MAY 26, 2022

Emily: And so even in the pandemic, we’ve seen circumstances like this where hospitals wrote allocation policies that were going to give preference to frontline healthcare workers in hopes, right, that they would incentivize them to stay on the job knowing that they would be taken care of and because they had been working for the public good.

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

MARCH 30, 2023

Today we’re going to be talking about narrative writing specifically for healthcare professionals. Then in the OpenNotes work that I do, I was hired to take something complicated like transparency and patients having access to their full records in medicine, and then making that something that the lay public understood.

IT 95

IT Patient-Centered Patients Healthcare 95

GeriPal

JANUARY 26, 2023

And again, that can create a food desert, which can create health issues for patients and their families, so that’s an example of structural racism, but again, it’s baked into laws. It’s baked into people’s belief systems, who ultimately make laws and make policies, and it can influence healthcare. Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

NOVEMBER 7, 2024

Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. He would go home, and then three weeks later he would be back in the hospital.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. And I’ll share that my own relationship with my father, who was a doctor, was a complicated one. They shared their experiences.

Community 115

Community IT Relationship Healthcare 115

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.

Patients 109

Patients IT Family Families 109

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

IT 99

IT Patient-Centered Patients Healthcare 99

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.

Family 93

Family Families IT Patient-Centered 93

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

MAY 25, 2023

Complicated grief? And, you know, I really leaned in from my perspective as a primary care geriatrician to hearing from what my patients and their family caregivers are asking me for and asking me about, and they’re asking me about how they can prepare. And that family was not necessarily a trusted network. Depression?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

JUNE 13, 2024

Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. And the truth is we don’t want, I don’t want any patient or family to perceive that when Brera goes to see me, there’s a second interest, a second gain. Alex 24:58 I’m so glad you mentioned the family.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. And this is really traumatic event for his street family and the street community that he knew. You know, we found that 64% of the people we cared for never went to the hospital or ER.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

DECEMBER 19, 2024

* This episode of the GeriPal Podcast is sponsored by the Zuckerberg San Francisco General Hospital Division of Hospital Medicine , which is committed to providing outstanding, compassionate care to all patients, advancing health equity, and fostering excellence in hospital medicine. For more details, please click here. (AP

Illness 101

Illness Mental Health IT Patient-Centered 101