Center for Family Medicine

MAY 7, 2025

Early detection of diabetes can help prevent complications like heart disease, kidney damage, and nerve problems. As the body loses more fluids through increased urination, it triggers a dehydration response, making individuals affected feel constantly thirsty. However, knowing when to get blood sugar levels checked can be confusing.

Diabetes 52

Diabetes Healthcare Professional Chronic Condition Family Medicine 52

Center for Family Medicine

MAY 14, 2025

Effective arthritis relief includes lifestyle changes such as regular low-impact exercise, weight management, and a diet rich in antioxidants. With appropriate treatment and proactive measures, individuals with arthritis can improve daily life while minimizing discomfort and adding years of relief.

Healthcare Professional 52

Healthcare Professional Patient-Centered Management Family Medicine 52

GeriPal

MARCH 14, 2024

We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. Eric: And for those individuals, do we know anything? This is Eric Widera.

IT 124

IT Hospital Patient-Centered Individual 124

GeriPal

OCTOBER 13, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MAY 19, 2022

I know this is like, we’re talking about math and so that makes it all a little complicated, but think about it this way. I really am not buying that it’s too complicated to do A over B, equal C over D, if you know three of the four variables. And then again, individualizing it to the patient. The old table, 1.5

IT 139

IT Patients Individual Relationship 139

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

JUNE 20, 2024

Incontinence and avoiding issues can present in an older individual, in some cases, just like they do a younger person. Biological aging or physiological aging varies from individual to individual. How do you think about this from a clinical perspective when you’re seeing individuals in your office? Everybody ages.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

JULY 19, 2024

What should we use to screen individuals? So I think we’re poised now with the guide model and with the evidence we have about healthcare utilization, impact on caregivers, course of dementia, comorbidity management and all of that. Who should get it if anyone? What happens after they test positive?

Screening 119

Screening Primary Care Patient-Centered IT 119

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. So we need to have a discussion upfront about how we’re managing the patient’s pain.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Rao Doctor

APRIL 3, 2025

When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Fever in infants under three months, a fever lasting more than three days, or a fever in individuals with weakened immune systems should be promptly addressed by a doctor for appropriate management and treatment.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

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

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

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. However, there are “Red Flag” symptoms that require urgent evaluation and management.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 52

Complication Patient-Centered IT Patients 52

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

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.

Family 102

Family Families IT Diagnosis 102

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

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? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JANUARY 25, 2024

It used to be a much more complicated model. However, its main predictors are age, comorbidity, and healthcare utilization. It was around helping communication, and really focused on our nursing manual, and particularly around these guidelines for assessing and managing symptoms. David: Right. David: Yeah. Eric: Okay.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

FEBRUARY 15, 2024

Katie: Well, if we just look at what we can do ourselves for our bodies, I mean strengthening, balance training, working on motor control, keeping ourselves fed so that we maintain our proper nutrients in our body so we can maintain an upright position, those are all key things an individual hopefully would be trying to do as best as they could.

Community 114

Community Transportation IT PCP 114

GeriPal

MARCH 28, 2024

Eric: And we’re going to get to results, but that’s why I also love that 2016 paper: I think it was the very first palliative care trial that ever looked at individuals getting curative therapy. 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

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. We talk a lot about people being unhoused, which I think takes the blame away from the individual and kind of de. Naheed 20:04 And you know, the key to this conversation is not to put the onus on individuals.

Healthcare 100

Healthcare IT Community Illness 100

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. Is the sort of task to manage. This is a complicated case. Summary Transcript CME Summary Serious illness communication is hard. Eric 40:08 Great.

IT 132

IT Illness Family Families 132

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

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. For example, here’s a quote from somebody at a high intensity hospital, “There’s a culture from the top of the healthcare system down. Liz: Right.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

APRIL 10, 2025

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. You’d have to tailor it to each individual emergency department because you couldn’t. No, no, no. It was very simple.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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. I highly encourage you. Kate 13:59 What did we do?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

JULY 28, 2022

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. They supported patients, they gave them a holding environment, they did symptom management, yada, yada, yada, like all the things we know palliative care clinicians do.

Illness 110

Illness Hospital Patient-Centered Patients 110

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 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. That’s just one hypothesis.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 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”?

IT 137

IT Family Families Physicals 137

GeriPal

OCTOBER 26, 2023

And so for pt, we’re generally focused on assistance with transfers, providing assistive devices to help people maintain independence with ambulation, doing stairs, leaving their homes, getting into the community, but really focusing on symptom management. Ann: Yeah, I’ll let Tamra speak if you want. Do you know those?

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

AUGUST 25, 2022

As a nurse case manager in hospice, half of my patients had dementia. Nurse case management, social worker case management, medications, medical equipment, a home health aid, all that stuff goes away. Melissa: The other scenario that exists is just disenrollment because an individual is hospitalized.

Family 106

Family Families IT Patients 106

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. Oh, yeah, yeah. Good artist. Really tasteful. I gotta get some sleep.

Illness 101

Illness Mental Health IT Patient-Centered 101

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

It sets space between us and the individuals we’re trying to take care of. I thought that was an interesting take on doing this, because a mother-daughter relationship can be complicated, can be wonderful, and it’s hard to navigate when you lose your mother. I often say that doulas are mirrors. Again, I go back to this.

Provider 117

Provider Illness IT Healthcare 117