GeriPal

OCTOBER 10, 2024

Today we talk with DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace about the notion that we should revolutionize our education programs, training programs, teams, incentive structures, and practice to be intentionally interprofessional in all phases. For instance, a family meeting or an update or communication with families.

Screening 119

Screening IT Family Families 119

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. We’ve done work with medical improvised, we’ve done work in museum based education. Alex 19:04 Yep.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. And the sort of the ask was, “Oh yeah, you can talk to the family, right?

Family 97

Family Families Patient-Centered IT 97

GeriPal

JANUARY 25, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

FEBRUARY 15, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Community 114

Community Transportation IT PCP 114

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. Tamra: I wrote this… Eric: Thinking that the perceived role for inpatient physical therapist is a discharge consultant.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

APRIL 4, 2024

Bernie Lo discloses being an Honorarium Recipient and consultant for Takeda starting on 01/23/2024. If they didn’t do it all by themselves, they talked to the family and it was a conversation, but also there wasn’t a whole lot that doctors can do then. AMA PRA Category 1 credit(s) ™. ICU care was pretty rudimentary.

Family 112

Family Families Patient-Centered IT 112

GeriPal

OCTOBER 12, 2023

” Somehow, there’s this signal that the patients and families had to pick up that maybe the surgeon wasn’t so enthusiastic, or if I just dump risk on them, maybe they’ll say, “I don’t want this.” And that’s how we connected. Justin: That’s probably the million dollar question.

IT 128

IT Family Families Patient-Centered 128

GeriPal

JUNE 19, 2025

Alex 00:41 And we’re delighted to welcome Noelle Marie Javier, who goes by “she” “her” and is a geriatrician and palliative care doc professor, newly minted – c ongratulations – And a clinician educator at Mount Sinai in New York City. If we think of discrimination, how people are treated by their biological family.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And there are no default pathways of family or friends to rely on and no known people who could potentially represent this person from within their inner circle.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse-based education to increase understanding of the spiritual dimension in healthcare. It’s since spread to over 70 VAs. Heather: Sure.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MARCH 28, 2024

It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality. Kate: I think the main one for me being asked on the fly is that one of the nudged specialist palliative care consultation, which we know has limitations. Eric: So how do you put that all together? Eric: Okay.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

JUNE 5, 2025

Kathleen 03:47 I think any of us who’ve spent any time in nursing homes have spent time working in a nursing home setting, have visited, had family members in nursing homes and looked around and seen the population there. So we see a lot of problems with symptom management, a lot of family conflict. That’s a big question.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

OCTOBER 24, 2024

Eloise 10:29 Yeah, I think what we saw in California was, prior to legalization, there was curiosity, but also a lot of their healthcare professionals didn’t know enough about it, so they didn’t discuss it with them. But you really should be looking at family history, personal history. Is that your feeling, too?

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

DECEMBER 15, 2022

So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live. So those questions we ask when we’re doing a palliative care consult.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 28, 2022

He uses comics and other artwork to share his experiences in palliative care and educate others about topics like empathy and communication skills. Here’s another clinician saying, “I ignored a patient’s tears and gave a speech about cardiac physiology during a family meeting.” That’s scare tactics.

IT 145

IT Hospital Patients Illness 145

GeriPal

FEBRUARY 13, 2025

You did a rural tele-palliative care consultation study. And so the video consult was what became the mode. Marie 03:42 So probably the most important thing is we developed the consultation as a culturally based consultation process. And then we incorporated that information into the consultation process.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

NOVEMBER 21, 2024

But if we’re going to have a family meeting, that’s a different circumstance. And so I let him educate me. It’s amazing how often when we’re taking care of somebody in the hospital, if you have Say, you know, a family member who is not showing up for visits with the medical team or who is.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

JANUARY 20, 2023

The technology committee however, is interested in using technology and coming up with a new set of goals, priorities and preferences and basing the process on working with nursing home residents, care partners or family members if they’re involved. And the technology piece, so doing less with staff. Jasmine: Technology.

Finance 95

Finance Board-Certified IT Provider 95

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. They may have few family members, live alone. I called my parents, and we talked.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

JANUARY 18, 2024

Alex: We are delighted to welcome back to the GeriPal podcast, Katie Fitzgerald Jones, who’s a nurse scientist at the New England Geriatric Research Education and Clinical Center, and a palliative and addiction nurse practitioner at the VA in Boston. Have you had a family history of substance use disorder? Should they?

Illness 136

Illness Patient-Centered Screening Clinic 136

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. And so we simply asked clinicians, have you offered this patient and, or their family the option of care focused on comfort? What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

APRIL 24, 2025

Daneila Lamas wrote about this issue in the New York Times this week -after we recorded – in her story, a family requested an herbal infusion for their dying mother via feeding tube. Jill Schneiderhan, a family medicine and integrative medicine doc, helps us think through this. Ivermectin to treat cancer. Stem cell treatments.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

MARCH 24, 2023

2021 Association of Hospice Profit Status With Family Caregivers’ Reported Care Experiences. I’m very proud of the work that we do every day and we take care of patients and families no matter where they live or who they are to help them meet their end of life goals. How do we make this work for patients and families?

IT 113

IT Provider Patients Family 113

GeriPal

APRIL 10, 2025

I think that study was really important, especially I think the message that I give people is you can do something as simple as calling a consultation and improve quality of life months later. And it’s very traumatic obviously for the family and all of that and the team really. So that’s great. It’s a hard outcome.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MARCH 10, 2022

The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. Whereas the home with the low rate of feeding tube use involved families in decision making. Whereas the high-intensity nursing homes tended not to have a process or did not include families. There was a hesitancy to engage black families.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MARCH 6, 2025

Just out of fellowship, Naheed built a palliative care program for homeless persons called the Palliative Education and Care for the Homeless (PEACH) Program. He’s the founder and leader of the Palliative Education and Care for the Homeless program in Toronto, Palliative care physician at St. Naheed 07:33 Yeah.

Healthcare 100

Healthcare IT Community Illness 100

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. Eric: When I try to think about what a doula does, should I call it a consult? That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

APRIL 14, 2022

So for those of you listening via YouTube, here’s the live version for those of you who are listening on the podcast, you’re going to get my prerecorded version with lots of loops and I’m doing consultation with my new music teacher who’s a music producer in LA. Alex: So we’ll see what these come out like.

Illness 102

Illness Patient-Centered IT Nurse Practitioner 102

GeriPal

JANUARY 11, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Illness 144

Illness IT Medical Provider 144

GeriPal

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

DECEMBER 5, 2024

I can remember two instances of storytelling in training or in education, I guess. And I was interviewing candidates for our clinical fellowship and interviewed Alexis, who had been like family medicine doc before, done all kinds of cool things. His lymphoma had relapsed, and palliative care was consulted to help with his symptoms.

IT 107

IT Community Patients Family 107

GeriPal

SEPTEMBER 5, 2024

She entertained her family. Thanksgiving’s coming up, you’re having your family, Christmas coming up. You’re going to go traveling to Hawaii with your family, and, you know, you want to die in January. But this lady continued to see me every three or four months and routinely asked me the very same question.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

SEPTEMBER 19, 2024

Alex 10:53 Yeah, or like palliative care if they get a consult for whatever reason, but not trn consult, like standardized, you know, randomized to palliative care versus whatever they’re doing before. If they get palliative care consult, they get one. If they don’t, they don’t. It’s not case finding.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

APRIL 26, 2024

ELNEC (End-of-Life Nursing Education Consortium) celebrates it’s 25th anniversary in 2025. He is a palliative care physician at the Durham VA Medical Center in Duke and blogs on Substack at Notes from a Family Meeting. It’s all stemmed from a post that Josh wrote, I’ll caught from his Substack Notes from a Family Meeting.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” So this, I think we had three or four consults.

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

GeriPal

JULY 25, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Family 106

Family Families Patient-Centered Patients 106