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. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JULY 19, 2024

What should we use to screen individuals? And either of those could be given to the patient or an informant. Anna 43:15 I mean, yeah, as I’ve had, I think in general, primary care doesn’t have a lot of information about how to use these things. Who should get it if anyone? What happens after they test positive?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MAY 11, 2023

But I would say that in terms of education, it’s really complicated because it’s so confounded by socioeconomic status and so many social determinants of health. There’s not that much information on smoking and cognition. Or is it going to get worse because they’re now having these complications from lecanemab?

Physicals 85

Physicals IT Hypertension Education 85

Rao Doctor

APRIL 3, 2025

This information can help pinpoint possible causes of illness and guide further investigations. While mild fevers often resolve on their own, persistent or severe fevers warrant professional evaluation. Using these methods can reduce temperature discomfort and minimize complications. And I do this regularly.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 12, 2025

But two, a very close relationship with potentially the palliative care physician or the individual who’s Sort of managing their pain, because the simulation itself can be 20 to 30 minutes of lying in that specific treatment position. Sometimes individuals have lung tumors that make it difficult for them to breathe.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Vida Family Medicine

JUNE 29, 2022

A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms. The healthcare system must provide care in a just way so that those who need care have access to it. What Roe v.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. Infections or allergic reactions can block your airway and lead to life-threatening complications.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

JULY 21, 2022

If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. But I think then the other factor in this that makes it complicated is the decision for someone in Manhattan might be very different than the decision for someone in, like, rural Wyoming. Alex: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

FEBRUARY 15, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. I mean, we work at a different part of the health system a lot of times, although we have acute care therapists who do the same thing, but the gap in information flow is similar.

Community 114

Community Transportation IT PCP 114

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

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

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 IT Individual Healthcare 87

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. And one of the hardest things is to distill it down to a sentence or two about what is information, what does it mean? This is a complicated case.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is Eric Widera.

Families 97

Families Family Patient-Centered IT 97

GeriPal

JANUARY 25, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. It used to be a much more complicated model. However, its main predictors are age, comorbidity, and healthcare utilization. Eric: How about you, David? David: Right. David: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. They are complicated.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

MARCH 9, 2023

Alex: It’s complicated. We, for very complicated reasons, ended up with niacin. Brian: I mean, bottom line in clinical research or psychedelic medicines, we don’t have a lot of information on safety anyway, and we definitely don’t have it in older adults. So, creating a- Alex: Control condition. Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

MAY 25, 2023

Complicated grief? Sarah: Yeah I similarly feel like, you know, focusing more on the process, the qualitative kind of from a research standpoint, the qualitative information that we’re getting from folks. And then individuals will still have questions of really, how can I help my wishes to be known? Did they have PTSD?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

MAY 4, 2023

Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. The whole idea of holding hope seems also so much more complicated for younger people because the hopes that they had, the normal hopes are not likely to be realized. What are the patients that we remember? Abby: Yeah.

IT 83

IT Family Families Illness 83

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. What we hear is that it is more trauma informed in many contexts to have people first language.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 15, 2025

At one end of the spectrum you can provide decision makers with information that doesn’t work very well in most contexts. 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.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

JUNE 16, 2022

Very interested in decision making around as we get older, individualizing care, sort of patient centered, values driven, it’s a tough decision to figure out. I appreciate that information. Eric: So this is a complicated pathway, right? Lots of information in there. Chrissy: That’s fascinating. Chrissy: Right.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

MARCH 24, 2022

Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. So it’s an example of something that can start outside of the healthcare system and move its way in. And the reality is they don’t.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

FEBRUARY 8, 2024

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. Between those two things, usually you get all the information you need.

IT 137

IT Family Families Physicals 137

GeriPal

APRIL 10, 2025

But we felt like we want to give like the primary thing about clinical decision support is to give the provider information they don’t already have. Do they have documents in the record like medical orders for life sustaining treatment or a healthcare proxy? The emergency physician knows it’s not new information.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

OCTOBER 26, 2023

I know that from Sarguni, we have some population level data, but are there any individual tools that you could use like an e-prognosis for function for hospitalized older adults? Tamra: It’s incredibly complicated because to date, there’s not really a validated tool that’s mandated to be used across all settings.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

AUGUST 24, 2023

Had multiple physical, psychological complications as a result of that. Just an extraordinary cast of individuals who were really so incredibly inspiring. I guess one question for providers is, as we dive into individual sense of dignity, and I guess threats to that dignity, is potentially feeling like we’re opening this box.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. Eric: I think about it as the first one to address individuals’ curative therapy. I don’t want to misspeak because now I forget.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

JANUARY 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. So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 29, 2025

Andrew complicates this definition , stating it raises more questions than answers. And then I think the flip side of that is we don’t deal with it as clinicians and help them understand how to interpret that information. And like, she retained that information for so long, but she does not really Speak. And the Clin.

Family 93

Family Families IT Patient-Centered 93

GeriPal

NOVEMBER 7, 2024

Or is it just this lingering practice of starting dialysis early before really severe complications develop? So we created these heat maps where you could see for each individual what actually happened in the days and you. Alex 06:10 Or having watched that John Oliver episode about DaVita, we will have a link. And we have these.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

JUNE 9, 2022

They need, they need some, a little bit of information and probably a little more than that, what we like to call an edge. Because we know information provision, I think it was the support trial, even giving them information about poor prognoses didn’t change their practice. That gets really complicated as well.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

DECEMBER 14, 2023

And so the combination of the institutional structures, as well as the extreme cases that each individual doctor feels will actually help create this different culture, be it high or low intensity. It’s not explainable that each individual physician has independently arrived at this very aggressive practice pattern.

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. The black individuals wanted to have a separate one from the white individuals.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MARCH 7, 2024

It sets space between us and the individuals we’re trying to take care of. And then, I did a lot of introspection and realized that I’ve actually been doing this for folks in an informal way, family church members and friends, but I didn’t do it so well with my own mother. I often say that doulas are mirrors.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

OCTOBER 19, 2023

Eric: So Scott, two questions for you then is since this is aimed, POLST is people with limited life expectancy, we also have no randomized control trials of CPR of individuals in this population. So I do think it’s useful to have that additional information. Eric: That’s a complicated form then. I want designation.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

JULY 28, 2022

So their practices were really collaborative and informed. So we know that when we cultivate illness and prognostic awareness, patients make more informed decisions about their care, both in terms of their medical care, but in terms of their life decisions and their priorities and their values. And those two are closely aligned.

Illness 110

Illness Hospital Patient-Centered Patients 110