GeriPal

JUNE 8, 2023

And yet we’re also in a different place in diabetes monitoring and management. 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.

Diabetes 73

Diabetes Management Patient-Centered Family 73

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.

Screening 119

Screening Primary Care Patient-Centered IT 119

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 Preventative Care Preventive Care Families 100

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. Eric: So this is a complicated pathway, right? Summary Transcript Summary.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. This is Eric Widera. Alex 00:12 This is Alex Smith. So we got a lot to cover.

Management 116

Management Patient-Centered Patients IT 116

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. Is the sort of task to manage.

IT 132

IT Illness Family Families 132

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.

IT 102

IT Family Families Diagnosis 102

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. Amy 12:23 I find this one.

Patient-Centered 109

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? Should she be treated non-operatively, with aggressive symptom management? And I came to the now I think naive conclusion that fixing and avoiding complications was the secret.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 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. 2023 Dec 20:S1524-9042(23)00202-3.

IT 137

IT Family Families Physicals 137

GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Because I might be able to cope and manage in one situation with the skills and supports that I have, and with those same skills and supports, and another situation kind of come unraveled. Brianna 00:41 Thanks.

Illness 129

Illness IT Diagnosis Patient-Centered 129

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? They want to be able to manage their own symptoms. Is that your feeling, too? Does that have face validity?

Medical 98

Medical IT Patient-Centered Healthcare 98

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

NOVEMBER 21, 2024

Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? But if we’re going to have a family meeting, that’s a different circumstance. That’s how I managed without screaming at my 4 year old who was coping. So help serves and hinders in everybody.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

MAY 22, 2025

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. We introduce it to families and patients and explain how it works and show them. Relationships are usually more complicated.

IT 96

IT Patient-Centered Patients Board-Certified 96

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

In particular, she reminds us that when we think about the most challenging of our patient encounters, they almost always involve a complex psychosocial dynamic, and this has received far less attention than communication and symptom management issues. . There was no conversation with the patient or the family about this.

Illness 109

Illness IT Family Families 109

GeriPal

DECEMBER 14, 2023

And it was amazing just seeing the differences in how end-of-life care is managed at those three institutions, which were all a subway right away from each other. ” And they’re like, “Well, it would be unethical not to talk to the family.” I guess the VA is federal though. Liz: Right. Liz: Yeah.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

JUNE 13, 2024

Alex 00:20 Today we’re delighted and honored to welcome Eduardo Bruera, who is one of the biggest symptom management gurus, if not the biggest symptom management guru in palliative medicine. If the patient has a spectacular response to HIV management or the cancer treatment, then the main factors are removed.

Illness 133

Illness Patient-Centered Patients IT 133

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

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. As a nurse case manager in hospice, half of my patients had dementia. And I had a blast playing Take the Money and Run! AlexSmithMD.

Family 106

Family Families IT Patients 106

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.”

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

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. We have our social workers and our psychologists and we know how to manage these symptoms. They’re because of the treatment.

Consulting 115

Consulting Patient-Centered IT Patients 115

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. Same thing with kind of medication management. Welcome, Katie, to the GeriPal podcast. Katie: Thanks for the opportunity. This is a first for our GeriPal podcast, right, Alex?

Community 114

Community Transportation IT PCP 114

GeriPal

JUNE 15, 2023

Matt: I was going to say that you said something very clearly that we’ve heard in our NIH funded study around AI based prognostication talking to patients and family members and so on, that there’s a comfort level when it’s being used to identify people who might benefit from palliative care or benefit sooner.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

FEBRUARY 16, 2023

Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. 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.

Patients 109

Patients IT Family Families 109

GeriPal

MAY 15, 2025

And so we simply asked clinicians, have you offered this patient and, or their family the option of care focused on comfort? But you know, we managed to work it through and people got used to it and throughout the duration of the trial. Because it’s complicated and we don’t want to over complicate prayer listeners.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

NOVEMBER 17, 2022

The songs about how saving lives is actually a pretty complicated business. ” And the requests from management were to ask her to prescribe antipsychotics to try and sedate some of these behaviors away. And that’s the complication here is there’s so many things that the staff can be trained on. Alex: Yeah.

Community 97

Community IT Mental Health Medical 97

GeriPal

MARCH 3, 2022

And then when I did residency in internal medicine first, there was just a lot of focus on a lot of heroic management in the ICU that didn’t always appeal to me without thinking about what the morbidity might look like. I think we’re probably managing sicker patients on the floor. Alex: What happens when people survive?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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

MARCH 6, 2025

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. 80% died exactly where they wanted to and 83% were reconnected to family or friends through a psychosocial support system that we put into place. Yeah, yeah.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. But from what we read was much better as century back, is in communities manage their own affairs.

Community 115

Community IT Relationship Healthcare 115

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. ” I think the family would like you to consider how to work with that.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MAY 26, 2022

To that point, in your article, you note that vaccination rates among blacks and Latinx individuals have been higher than whites according to a Kaiser Family Health news report. And then being on a scarce resource committee during March, April 2020, man, it got really complicated and we spent hours and days trying to figure things out.

Vaccination 87

Vaccination IT Individual Healthcare 87

GeriPal

APRIL 10, 2025

And it’s very traumatic obviously for the family and all of that and the team really. It was like this patient is on hospice and call the case manager to figure out how the patient ended up here. Yeah, that’s a more complicated story. But yeah, it’s complicated. Corita 10:59 No, it was rather simple.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77