GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. And yet we’re also in a different place in diabetes monitoring and management. Eric: And you can probably tell already, the topic at hand is diabetes management in late life.

Diabetes 74

Diabetes Management Patient-Centered Family 74

PEMBlog

OCTOBER 2, 2024

I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. The role of lifestyle and dietary modifications in management. Gastroesophageal Reflux: Management Guidance for the Pediatrician.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

JUNE 12, 2025

Summary Transcript CME Summary If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. Anish 01:02 Well, I speak, you know, from a physician lens of some of the patients that I get referred, and by the time there’s. This is not a good option.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Guests Alex Gamble and Brianna Williamson have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Understanding the patient’s medical history is crucial for an accurate diagnosis. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

Plum Health

OCTOBER 11, 2024

It's the first point of contact for all your medical needs, from routine check-ups to managing chronic conditions. These services go beyond treating illnesses; they aim to keep you healthy in the first place. Do you prefer a full-service medical center or a walk-in clinic? It's not quite an emergency, but you need relief fast.

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

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

NOVEMBER 21, 2024

We are going to tackle this question and so many more about coping on this week’s podcast with Dani Chammas , a recurring GeriPal guest, psychiatrist, and palliative care doc at UCSF, and Amanda Moment , a Palliative Care Social Worker at Brigham and Women’s Cancer Center. Coping in the setting of serious illness.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. But the patient would say, well, but it still hurts, though.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. Kirsten 04:16 So, in emergency medicine, obviously, we are interacting and caring for these both exciting and interesting, but also very complex and humbling patients to care for in the ED setting. What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. 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? Summary Transcript Summary. AlexSmithMD.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center.

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. – Serious Illness Conversation Guide podcast. There was no conversation with the patient or the family about this. AlexSmithMD .

Illness 109

Illness IT Family Families 109

GeriPal

JUNE 15, 2023

Alex: And we have Matt DeCamp, who’s joining from the University of Colorado, where he is a primary care internist and bioethicist at the Center for Bioethics and Humanities. My worry though with that is that are we going to be expected to be more productive then, to see more patients? The patient is crying in front of you.

IT 99

IT Patient-Centered Patients Healthcare 99

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? Tons of interviews, bringing in real patients, talking about the science, both. They just kept at it.

Medical 99

Medical IT Patient-Centered Healthcare 99

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

MARCH 28, 2024

And we have Kate Courtright, who’s at University of Pennsylvania, the PAIR Center. What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Kate: These are very sick patients. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades. Alex: Thank you.

Illness 144

Illness IT Medical Provider 144

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. The illness narratives suffering, healing, and the human condition. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. I did it before and this guy, he was 85, but he was climbing Mount Everest.”

IT 128

IT Family Families Patient-Centered 128

GeriPal

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. But in the end, I see these as my patients and I’m trying to define what is the right model. My wife is also a physician and she said he’s dying.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

NOVEMBER 17, 2022

staff training in person centered care). 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. Staff training on person-centered care. Alex: Yeah. Eric: Nice.

Community 97

Community IT Mental Health Medical 97

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. So we’re going to be today talking about serious illness palliative care in the homelessness population. I’ll just throw out there people with serious illness experiencing homelessness.

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. It was wonderful for me, as a rehab doctor, to be able to see patients with spinal cord injuries and how they were living in their homes.

Community 115

Community IT Relationship Healthcare 115

GeriPal

FEBRUARY 24, 2022

Juliet and Rachelle are two of the authors of a recent JAMA viewpoint titled “Shifting to Serious Illness Communication.” . Also see the image below from Alex’s editorial in JAGS , a Venn diagram of advance care planning and serious illness communication. Shifting to Serious Illness Communication. Transcript. What is it?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. Get to learn some Spanish for this one.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

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. Health care professionals are human, and as humans we experience loss both in and out of work. Turns out, it’s maybe not.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102