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. But if we’re going to have a family meeting, that’s a different circumstance. Should I laugh at that? laughter] Eric 03:38 All right, Dani, I’ ve got a question.

Illness 125

Illness IT Patient-Centered Patients 125

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. And then be quiet and listen.

IT 132

IT Illness Families Family 132

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?” Anne Kelly: Hi there. Nice to be here. Eric: Lynn or Anne?

Family 97

Family Families Patient-Centered IT 97

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. Alex 24:58 I’m so glad you mentioned the family. There’s something.

Illness 133

Illness Patient-Centered Patients IT 133

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

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. A “Three-Stage Protocol” for Serious Illness Conversations: Reframing Communication in Real Time Transcript Eric: Welcome to the GeriPal podcast. Simple, right?

Family 144

Family Families Patient-Centered IT 144

GeriPal

MAY 4, 2023

There’s all this stuff that we’re supposed to be doing at that stage of life and then you add the complexity of the serious illness. It is really difficult for the patients and the families. Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues.

IT 83

IT Family Families Illness 83

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. Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

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). Love to talk about also in the serious illness population. Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? She falls and breaks her hip. She has advance dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

AUGUST 11, 2022

– Serious Illness Conversation Guide podcast. What I fell in love with and felt incredibly compelled by was the taking care of seriously ill patients and particularly helping them negotiate emotionally the experience of being very seriously ill. There was no conversation with the patient or the family about this.

Illness 109

Illness IT Families Family 109

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. . And especially for those who may have nontraditional families. This is Eric Widera.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Transcript. Eric: Yeah.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Tell us more about what you mean,” because they give us beautiful information from that. Pain Manag Nurs.

IT 137

IT Families Family Physicals 137

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

JULY 11, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. And so I was driven by the fact that I needed more information, and so it sort of became my clinical focus as well as I dabble in the research.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JUNE 15, 2023

Charlotta: Yeah, I think it will be in reducing the need to spend so many hours on documentation and looking through the EHR for information. And what we are seeing in our research is that, we’re working on GPT four, is volunteering information that we didn’t ask for. The information there and you limit it in that way.

IT 99

IT Patient-Centered Patients Healthcare 99

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. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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? I think the two spaces it comes out of, one is informed consent, which is this idea that people need to have an understanding of their disease and treatment.

IT 128

IT Families Family Patient-Centered 128

GeriPal

JUNE 9, 2022

We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. What does “early” really mean?

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

GeriPal

JANUARY 11, 2024

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. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. But that was separate from MAID.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 6, 2025

We discuss the principles of harm reduction, social determinants of health, and trauma informed care. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 22, 2025

We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Just encourage patients and families to bring music into their healthcare experience.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

OCTOBER 19, 2023

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. So I do think it’s useful to have that additional information. Alex: National POLST Collaborative. Good to know.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. He looked very ill. John: I am what I am, which is a family practice doctor. I’m unsure what they do, how often they’re used, and who pays for their work.

Provider 117

Provider Illness IT Healthcare 117

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. AlexSmithMD. Transcript. Melissa: Sure.

Family 106

Family Families IT Patients 106

GeriPal

DECEMBER 14, 2023

On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. And so I specifically chose hospitals that were at different intensities of care based on the Dartmouth Atlas around serious illness and end-of-life care.

Hospital 125

Hospital IT Patient-Centered Patients 125

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. And then we incorporated that information into the consultation process. And my community and about my family and those kinds of things.

Consulting 63

Consulting Community Patient-Centered Family 63

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. Did the caregiver feel heard and understood? Did they have PTSD? Depression?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness. David 12:34 Yeah.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Had multiple physical, psychological complications as a result of that.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. What feelings do we have toward the patient and toward their families? Keri: It’s all normal, and it’s all data that can better inform our practice. How did you react? Eric: Yeah.

Patients 109

Patients IT Families Family 109

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. Alex: What happens when people survive? Lauren: Yeah. Lauren: Yeah.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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

MARCH 28, 2024

We all, when bombarded with information have to take certain elements of a decision and focus on those; and in the ICU, you can imagine, we’re bombarded with information a lot. Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. We’ve had you on twice before.

Consulting 115

Consulting Patient-Centered IT Patients 115

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

SEPTEMBER 5, 2024

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. She entertained her family. Thanksgiving’s coming up, you’re having your family, Christmas coming up.

Patients 98

Patients IT Patient-Centered Hospital 98