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. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

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Hospital IT Patient-Centered Patients 125

My Green Doctor

JULY 2, 2025

Here we suggest steps that healthcare managers and clinicians can take to protect their patents. We hope you will discover resources to share with your family as well! The EIB developed a first-of-its-kind tool to quantify how climate hazards like heatwaves, floods, and poor air quality will drive up healthcare demand across Europe.

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Healthcare Healthcare Professional Management Community 52

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. Should you stop at “no?” We will have to reach out to your daughter then to help with decisions.

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Families Family Patient-Centered IT 97

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. I was really passionate about helping the people and also their families. David: Right.

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Patient-Centered IT Illness Patients 122

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. And you’re in the ICU family meeting, and it gets heated. So it’s a lot, but it’s good.

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IT Illness Family Families 132

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. For instance, a family meeting or an update or communication with families. And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. What do they turn to to cope?

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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. And I started my career at Barnes-Jewish Hospital in St. But rarely does the podcast and clinical reality meet in the same day.

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GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?”

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GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training.

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Consulting Patient-Centered Diagnosis IT 99

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

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Family Families Patient-Centered IT 112

GeriPal

FEBRUARY 15, 2024

Eric: Well, what are the odds that two family members focus on a similar topic and do research together? laughter] Alex: We love the family theme. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Welcome, Katie, to the GeriPal podcast. Katie: Awesome.

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GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

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Consulting Patient-Centered IT Patients 115

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. You get a consult if you get a consult.

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Telehealth Patient-Centered IT Patients 105

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.” What I need to navigate with that patient and their family, is it valuable to you? Every time.

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IT Family Families Patient-Centered 128

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.

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IT Patient-Centered Healthcare Illness 105

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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay.

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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.

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Patient-Centered IT Patients Healthcare 109

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Eric: Yeah.

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GeriPal

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. I was just thinking back to yesterday, we were in a family meeting.

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GeriPal

FEBRUARY 13, 2025

You did a rural tele-palliative care consultation study. Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. And so the video consult was what became the mode. NCP guideline, standard consultation.

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Consulting Community Patient-Centered Families 63

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. When they built a new prison hospital in Stockton, the dialysis went there. In many cases, the families were the victims of the crime. Michele: Yep.

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Family Families IT Community 132

GeriPal

JUNE 30, 2022

Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? Joel: Oh yeah.

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Patient-Centered Complication Patients IT 101

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.

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GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. hospice use). Tammie 02:56 It usually doesn’t work no matter what. So that’s great.

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Patient-Centered IT Hospital Patients 77

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

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IT Patient-Centered Patients Healthcare 99

GeriPal

OCTOBER 5, 2023

So I first want to just say thank you to Ernesto’s family. And I met with his family over Zoom, which was how many of us had to meet with families during that time. We were doing a lot of this without a whole lot of guidance, as is common, I think, from family, because all they knew was who he was. Sunita: Yes.

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Illness IT Patient-Centered Families 136

GeriPal

JULY 3, 2025

We’ve invited two palliative care doctors to talk about survivorship with us: Laura Petrillo , a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker , an outpatient palliative care doctor at the Cleveland Clinic. I was there and at University Hospitals, had a great visit. Great to see you guys.

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GeriPal

NOVEMBER 21, 2024

Alex 00:26 And we’re delayed to welcome Amanda Moment, who is a palliative care social worker at the Brigham and Women’s Hospital in Boston. But if we’re going to have a family meeting, that’s a different circumstance. What are you seeing in terms of the relationship between this patient and their family?

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Illness IT Patient-Centered Patients 125

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. Sue 01:26 Thank you.

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IT Patient-Centered Families Family 104

GeriPal

SEPTEMBER 22, 2022

And in response, the family or patient looked at you like you were from another planet? Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. Links: – Uncanny Valley post on Josh’s fantastic substack Notes from a Family Meeting.

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Illness IT Patient-Centered Patients 101

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?

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GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Rehabbed to Death.

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GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. Alex: I love the story of this book, how it starts so locally and then moves on to the Kerala region and then moves to India.

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GeriPal

FEBRUARY 16, 2023

So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond. What feelings do we have toward the patient and toward their families? And countertransference is everywhere.

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GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. And this is really traumatic event for his street family and the street community that he knew. You know, we found that 64% of the people we cared for never went to the hospital or ER.

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Healthcare IT Community Illness 100

GeriPal

OCTOBER 6, 2022

Alex: And we’re so delighted to welcome to the GeriPal Podcast Marian Grant, who is a palliative care nurse practitioner and marketing consultant, and she is at the University of Maryland Medical Center in Baltimore. Welcome back to GeriPal, Tony. Tony: Hey, thank you. Welcome to the GeriPal Podcast, Marian. Marian: Thank you.

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Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

DECEMBER 5, 2024

Alex 00:23 All right, first, we’re welcoming back Ricky Le it er, who’s a palliative care doc at Dana Farber Cancer Institute in Brigham Women’s Hospital and Harvard Medical School and is co-founder of the Palliative Story Exchange. His lymphoma had relapsed, and palliative care was consulted to help with his symptoms.

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