Center for Family Medicine

MAY 14, 2025

With appropriate treatment and proactive measures, individuals with arthritis can improve daily life while minimizing discomfort and adding years of relief. A pharmacist or doctor should advise on the best dosage to meet individual needs. Consulting a healthcare professional is crucial before beginning any new regimen.

Healthcare Professional 52

Healthcare Professional Patient-Centered Management Family Medicine 52

Physician's Weekly

JUNE 11, 2025

Chae : The four pillars of obesity care is a helpful framework that defines the essential elements of obesity care, which include nutrition therapy, physical activity, behavioral modification, and, if clinically indicated, medical interventions (eg, medication management, bariatric procedures, and complication management).

Management 52

Management Primary Care Physicals Telehealth 52

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?

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JULY 19, 2024

What should we use to screen individuals? 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.

Screening 119

Screening Primary Care Patient-Centered IT 119

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. I’m thinking of chronic pain, for example, and individuals with chronic pain often have disturbed sleep or other conditions.

Physicals 85

Physicals IT Hypertension Education 85

Vida Family Medicine

JUNE 29, 2022

These are intellectually interesting but often personally devastating to the patient and family involved. A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms. Medicine involves many extremely ethically challenging situations. What Roe v.

Family Physician 52

Family Physician Family Families Healthcare Professional 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). Were those people self referring, or family members calling you asking? Eric: Yeah.

Family 102

Family Families IT Diagnosis 102

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?” AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

Family 97

Family Families Patient-Centered IT 97

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. So I think it’s a bit of both acknowledging it and the emotion that may be in the room, but also just seeing the family. Alex 19:04 Yep.

IT 132

IT Illness Family Families 132

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. You have a patient with dementia severe enough that she cannot recognize relatives.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JULY 11, 2024

I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. And so I honestly think it has to do with how complex the diseases and the complications that come from it. Amy 12:23 I find this one. What’s the goal?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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

MAY 4, 2023

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. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous.

IT 83

IT Family Families Illness 83

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. I was really passionate about helping the people and also their families. David: Right. Eric: Okay.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

FEBRUARY 8, 2024

So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? Family member, and with some chagrin- Eric: Powerful nudge. What are you seeing?”

IT 137

IT Family Families Physicals 137

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. All of these are factors that are on the individual level. Welcome, Katie, to the GeriPal podcast. Katie: Thanks for the opportunity. Alex: I think this is a first. Katie: Awesome.

Community 114

Community Transportation IT PCP 114

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

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

DECEMBER 14, 2023

It’s the clinicians on the rounding team, yes, but also the multidisciplinary team is really important, how they support the patient, the family, the doctors, the nurses, but also how the broader institutional structures such as ethics committees, et cetera, how they support. Alex: I found your quotes particularly hard hitting here.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. It’s baked into people’s belief systems, who ultimately make laws and make policies, and it can influence healthcare. The same thing happens in geriatrics.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

MAY 15, 2025

We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. We tested two different nudges individually and then we combined them. Their family members want them to get out of the hospital sooner.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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

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 9, 2023

Alex: It’s complicated. We, for very complicated reasons, ended up with niacin. One of the headlines there was about a family medicine doc, not to pick on family medicine, a doc, who was prescribing mail order psychedelics at really high volumes around the country. So, creating a- Alex: Control condition.

Patient-Centered 91

Patient-Centered Community IT Medical 91

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. John: I am what I am, which is a family practice doctor. It sets space between us and the individuals we’re trying to take care of.

Provider 117

Provider Illness IT Healthcare 117

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. We provide critical conversations with colleagues and families to coordinate transition planning.” Do you know those?

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

JUNE 16, 2022

Alex: Today we are delighted to welcome Chrissy Kistler, who is a geriatrician researcher in the Department of Family Medicine and Vision of Geriatrics at the University of North Carolina, Chapel Hill. Eric: So this is a complicated pathway, right? Can we help families as well as our nurses and everybody get there?

Management 122

Management IT Medical Patient-Centered 122

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

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. The black individuals wanted to have a separate one from the white individuals. And my community and about my family and those kinds of things.

Consulting 63

Consulting Community Patient-Centered Family 63

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. How do you make decisions about work and family? Alex: I’ve got to show you the back of the Jersey.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. So we have the intervention is a big part. Again, it’s not the only part. Karl: Okay.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MARCH 6, 2025

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. And this is really traumatic event for his street family and the street community that he knew. those experiencing homelessness).

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MARCH 28, 2024

I am part of some other work in the ICU world looking at time-limited trials and trying to better define what those are, how we talk about them, how we talk about them with patients and families. Eric: I think about it as the first one to address individuals’ curative therapy. Tom: That’s probably true.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

MAY 12, 2022

When we think about palliative care delivered here, like individuals with chronic pain, non-serious illness chronic pain, non-life threatening illness, oftentimes if we get consulted on them, we don’t even see them, may just be discontinued in most palliative care places. I’m not sure he would really approve.

Community 115

Community IT Relationship Healthcare 115

GeriPal

JUNE 9, 2022

But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. That gets really complicated as well. Alex: It gets very local and individualizes as you were saying.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99