GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Katie, before we jump into the topic of buprenorphine in serious illness, what’s the song request?

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Illness Patient-Centered IT Patients 102

GeriPal

JANUARY 18, 2024

Eric: And Alex, we’re going to be talking about substance use disorder and serious illness and aging, with three amazing experts. Eric: So, before we jump into the topic of substance use disorder in aging and serious illness, I think someone has a song request. Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera.

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Illness Patient-Centered Screening IT 136

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.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Eric 01:42 So we’ ve got an exciting topic today.

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IT Illness Family Families 132

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. So I first want to just say thank you to Ernesto’s family. Eric: And can you tell me about Ernesto? Sunita: Yes.

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Illness IT Patient-Centered Family 136

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.

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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

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?” Anne Kelly: Hi there. Nice to be here. Eric: Lynn or Anne?

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Families Family Patient-Centered IT 97

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. Bennett, C.R.,

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Patient-Centered Illness Healthcare IT 115

GeriPal

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. We had tried to actually select people who didn’t have a serious illness. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

JUNE 9, 2022

We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. What does “early” really mean?

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Consulting Patient-Centered Diagnosis Referral 99

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. But watch out! Alex 01:06 Yeah, go in person.

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Telehealth Patient-Centered IT Patients 105

GeriPal

MAY 4, 2023

There’s all this stuff that we’re supposed to be doing at that stage of life and then you add the complexity of the serious illness. It is really difficult for the patients and the families. Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team. Young adulthood is super hard.

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IT Family Families Illness 83

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 so I knew that I wanted to do something related to palliative care because I work with people with advanced and serious illness.

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Patient-Centered Hospital Patients IT 132

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. Tell me about your illness. How did you get into this? Heather: Sure.

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IT Patient-Centered Healthcare Illness 105

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. What words to use? Is the POLST useful? Under what circumstances?

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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.” 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

MARCH 28, 2024

It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality. Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. But importantly, it did not change the frequency of comfort care orders. Kate: Sounds right.

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Consulting Patient-Centered IT Patients 115

GeriPal

JUNE 15, 2023

Because the in serious illness care and care for older adults, their care is often very complex. So there’s some stuff out there like that, but also using AI to determine who at high risk and should get a palliative care consult. Matt: I think you’re also… Go ahead. Charlotta: No, I totally agree with Sei.

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IT Patient-Centered Patients Healthcare 99

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. So those types of relationships, clergy, non family members, we talk about, I think cohabitating unmarried couples. Is that fair? Tim 11:59 Yeah.

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Patient-Centered IT Patients Healthcare 109

GeriPal

JUNE 5, 2025

nursing homes grapple with serious illnesses, and roughly half experience dementia. 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. Cognitive impairment.

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GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. But that was separate from MAID.

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Illness IT Medical Provider 144

GeriPal

JUNE 30, 2022

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? We think there are some cases, certain kinds of illnesses or conditions or operations, where people have the surgery and never get out of bed again. She has advance dementia. Eric: Yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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. Where was it?

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Patient-Centered Hospital IT Illness 116

GeriPal

APRIL 28, 2022

Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. We have all made mistakes in the language we use, the words we use and sometimes, in palliative care or in care of people with serious illness, that puts us in jail. Nathan: Hello, excited to be here.

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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.

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Consulting Community Patient-Centered Family 63

GeriPal

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. And this really allowed, I think, other people to celebrate themselves and the families, family members who are going through the same type of journey. Happy pride and thanks for the invitation, Alex and E.

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Individual Community IT Chronic Condition 85

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. But now we have older people dying of older people illnesses. In many cases, the families were the victims of the crime. Michele: Thank you for having me.

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Family Families IT Community 132

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. If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Ivermectin to treat cancer.

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Patient-Centered IT Patients Illness 77

GeriPal

DECEMBER 14, 2023

On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. And so I specifically chose hospitals that were at different intensities of care based on the Dartmouth Atlas around serious illness and end-of-life care.

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Hospital IT Patient-Centered Patients 125

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. He looked very ill. John: I am what I am, which is a family practice doctor. I’m unsure what they do, how often they’re used, and who pays for their work.

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Provider Illness IT Healthcare 117

GeriPal

OCTOBER 24, 2024

Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness. But you really should be looking at family history, personal history.

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Medical IT Patient-Centered Healthcare 98

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. JAMA Health Forum. Eric: Great. They are legitimate.

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IT Provider Patients Family 113

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. So we’re going to be today talking about serious illness palliative care in the homelessness population.

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Healthcare IT Community Illness 100

GeriPal

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. by Kearney. I promise its short. And they did. Eric 13:14 Okay.

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IT Patient-Centered Family Families 104

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. What feelings do we have toward the patient and toward their families? And here’s an incredibly angry family member. How did you react? Afterwards, I thought there must be a better way.

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Patients IT Family Families 109

GeriPal

MAY 12, 2022

When we think about palliative care delivered here, like individuals with chronic pain, non-serious illness chronic pain, non-life threatening illness, oftentimes if we get consulted on them, we don’t even see them, may just be discontinued in most palliative care places. What do you think about that?

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