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. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. Is that right, Soo? Soo 00:32 Thanks.

Screening 119

Screening Primary Care Patient-Centered IT 119

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 73

Diabetes Management Patient-Centered Families 73

Mesa Family Physician

MARCH 13, 2025

However, at Mesa Family Physicians , we believe that preventive healthcare is the cornerstone of long-term wellness for our Mesa, Arizona community. Regular visits to your primary care physician at Mesa Family Physicians provide opportunities for early detection of potential health issues before they become serious problems.

Family Physician 100

Family Physician Preventive Care Preventative Care Families 100

GeriPal

MAY 11, 2023

I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. Now, that doesn’t mean it’s a one-to-one, and this is very hard as we see it with our patients who have done all these things.

Physicals 85

Physicals IT Hypertension Education 85

Vida Family Medicine

JUNE 29, 2022

I want to respond to the many strong emotions and fears expressed by many of my patients regarding the recent Supreme Court decision overturning of the Roe v. I try as much as possible to avoid political and polarizing topics with my patients because I recognize that we all have different beliefs, and that is okay.

Family Physician 52

Family Physician Families Family Healthcare Professional 52

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. Why did you all decide to write an updated book on navigating communication with serious ill patients?

IT 132

IT Illness Families Family 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?” Anne Kelly: Hi there. Nice to be here. Lynn: I do.

Families 97

Families Family Patient-Centered IT 97

GeriPal

FEBRUARY 16, 2023

Summary Transcript Summary Think about the last time a patient yelled at you in anger. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Ask why: What is underneath the anger for this particular patient? Taking care of the hateful patient.

Patients 109

Patients IT Families Family 109

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?

Families 144

Families Family Patient-Centered IT 144

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. What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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? The article we discuss today, also published in JAMA , addresses these two gaps. Big randomized control study that came out. Important implications.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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). Initially, it was just because there weren’t really answers for my patients.

Families 102

Families Family IT Diagnosis 102

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 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

NOVEMBER 14, 2024

Summary Transcript CME Summary Falls are very common among older adults but often go unreported or untreated by healthcare providers. Patients may feel like falls are just part of normal aging. I think both the patients feel that. And if the answer is yes, then the patient’s at risk. A fall related injury.

IT 124

IT Screening Patient-Centered Community 124

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 98

Medical IT Patient-Centered Healthcare 98

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? Alex: How is your family doing?

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery. AlexSmithMD.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for.

IT 83

IT Families Family Illness 83

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 Families Family Physicals 137

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 Families Family Patient-Centered 128

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 125

Illness IT Patient-Centered Patients 125

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

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 129

Illness IT Diagnosis Patient-Centered 129

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

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

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.

Illness 109

Illness IT Families Family 109

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. Eric: Well, what are the odds that two family members focus on a similar topic and do research together?

Community 114

Community Transportation IT PCP 114

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. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Families 106

Families Family IT Patients 106

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

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

JULY 28, 2022

This is my early father’s day gift from the family. 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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right.

Illness 110

Illness Hospital Patient-Centered Patients 110

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 133

Illness Patient-Centered Patients IT 133

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 116

Patient-Centered Hospital IT Illness 116

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. The trainee said to me something like, “But I haven’t seen any geriatric patients yet.” Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

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

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 115

Consulting Patient-Centered IT Patients 115