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

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

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

OCTOBER 20, 2022

There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. It’s another article, another major article that has triggered the complicated UTI circuit. But what I did want to highlight is how we got to thinking about men that have UTIs have complicated UTIs.

Patient-Centered 52

Patient-Centered Complication IT Patients 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. Absolutely.

IT 102

IT Family Families Diagnosis 102

GeriPal

MARCH 28, 2024

Well, as a kick off to this year’s first in-person State of the Science plenary, held in conjunction with the closing Saturday session of the AAHPM/HPNA Annual Assembly, 3 randomized clinical trials were presented. And when I presented it to the transplant team, they said, “This is interesting, but we don’t need that.

Consulting 115

Consulting Patient-Centered IT Patients 115

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

NOVEMBER 17, 2022

AlexSmithMD (still on Twitter at present). The songs about how saving lives is actually a pretty complicated business. So, the top two were that assisted living communities, in those communities the resident should be present during assessment and care planning. Transcript. Eric: Welcome to the GeriPal podcast. Alex: Yeah.

Community 97

Community IT Mental Health Medical 97

GeriPal

NOVEMBER 21, 2024

Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? Eric 11:58 So going back to the case that you presented at the start, so you’re seeing this person use a whole lot of humor. That’s how I managed without screaming at my 4 year old who was coping.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

MARCH 6, 2025

He was a person with schizophrenia, he was a person who used drugs and he presented in pain crisis to our shelter. So, you know, I just wanted to present a couple options and give you a sense of, you know, the background for both. How much of your training was focused on managing substance use disorder training and palliative care?

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 26, 2023

But one of the things I’m really interested in is people have agency and autonomy, so we can present them with the scenarios of best case, worst case, and they will always choose what’s most important to them. But really how are we talking about that as a team? Ann: Yeah, I’ll let Tamra speak if you want. Do you know those?

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

MAY 22, 2025

So I actually was doing a grand rounds as my final presentation here at Yale for my fellowship on the role of music in host pice and palliative medicine. Relationships are usually more complicated. You emailed me about doing a podcast on music and medicine. I’m wondering, why did you think it was a good idea to do this podcast?

IT 96

IT Patient-Centered Patients Board-Certified 96

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. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004. 2023.11.004. Epub ahead of print.

IT 137

IT Families Family Physicals 137

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. Jane, welcome to the GeriPal podcast. Jane: Thank you for having me. John: Yeah.

Provider 117

Provider Illness IT Healthcare 117

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? And Eric, you’ll have to remind me what the fourth paper is called because- Eric: Present Downsides, Not Just Risk. So dad asked, “Oh, great. When can I see again?”

IT 128

IT Families Family Patient-Centered 128

Tiny Physician

MARCH 30, 2022

The bystanders of the patient who were present at that time understood the efforts taken by the doctors and told the treating team that the doctors did their best and it was the patient’s fate. Postpartum hemorrhage is an unfortunate and well-known complication of delivery. Nevertheless, she succumbed to the massive bleeding.

Hospital 52

Hospital Government Patient-Centered Medical 52

GeriPal

APRIL 10, 2025

Alex 10:52 And did you have algorithms you’d present to them, like given this patient’s circumstance, these are recommendations? 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.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

SEPTEMBER 7, 2023

So I will say that it’s challenging, because we don’t have, unlike City of Hope, we don’t have a big team like they do of geriatricians and palliative care physicians, who can screen these older adults or help with management. William: Not the future, but the present. It’s really up to the oncologist.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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

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. I think it’s very present in maid.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

FEBRUARY 16, 2023

Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. Dani: Yeah, so the way you presented was triggering to them. Dani: Yeah, good question.

Patients 109

Patients IT Families Family 109

GeriPal

JANUARY 11, 2024

You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). 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. Eric: Bill. Bill: Yeah. Eric: Thank you Bill.

Illness 144

Illness IT Medical Provider 144

GeriPal

AUGUST 24, 2023

Had multiple physical, psychological complications as a result of that. We published a nice piece, I think it was in the Journal of Pain and Symptom Management. I’m fully present. That the wish to… Eric: Complicated. Harvey: Complicated. She died at the age of 55, and was born with cerebral palsy.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

NOVEMBER 3, 2022

You’d imagine though that our professional expertise and experiences in helping patients and families cope with loss and grief would be helpful in managing our own personal losses. These debriefings create a safe outlet for health care professionals to talk about the feelings resulting from their work. Turns out, it’s maybe not.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

GeriPal

MAY 1, 2025

But the HIV we do see, and it feels tragic because the people who are dying of and affected by the more kind of traditional, if you call it that, kinds of complications, some of which can be fatal of HIV AIDS are the people who are not on treatment. And usually there’s a reason for that that is hard to sometimes overcome.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

JULY 25, 2024

So snaps to Ricky, but he presented this case to us of a person who had had a heart operation. And as things sometimes happen in surgery, patients can experience complications and one complication, particularly in someone who’s frail, who’s not buying the cabbage, maybe they’re buying the chard at the farmer’s market.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

But most people with dementia are initially diagnosed and medically managed in primary care, and they really desire clinicians to initiate these conversations but there are a number of really important barriers for these conversations taking place. The intervention itself is very straightforward. You know, all of these things I think are.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

JUNE 6, 2024

Areej 03:50 So at the state of the science, I was actually presenting a study that was focused on addressing sexual health concerns in transplant survivors, and I actually told the story of the state of the science for those of you who were there. Again, it’s this multidimensional, it’s complicated, but we talk about it.

Illness 130

Illness IT Physicals Patients 130

GeriPal

FEBRUARY 24, 2022

And I think the advanced planning debate is really a question of, how do we help this very complicated situation? But one of the things that I try to teach, because both Juliet and I have done a ton of teaching about this, is that if you follow these steps, that outcome sort of presents itself. We see how hard it is.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

AUGUST 22, 2024

Right, my answer that brings us a little bit closer to the present than my childhood. And then another, which was released under the Bush administration by a council with a different sort of philosophical Benton worldview which still managed to come to the same conclusion in support of a brain based definition, death.

IT 113

IT Families Family Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis. By the year 2000, everyone will be in a Medicare managed care plan.” Annals of Int Med. 2020 Hospital at Home-Plus: A Platform of Facility-Based Care.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115