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. Rather, most of us live and make decisions in relationship to one another. Nice to be here.

Families 97

Families Family Patient-Centered IT 97

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.

IT 132

IT Illness Family Families 132

GeriPal

OCTOBER 10, 2024

For instance, a family meeting or an update or communication with families. I’ve worked in palliative care for years, and there’s some times where I’m in the family meeting, I’m facilitating the family meeting, and then I’m reporting out to the referring doctors, and I say, what happened?

Screening 119

Screening IT Family Families 119

GeriPal

JANUARY 25, 2024

Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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

APRIL 4, 2024

Widera and Smith have no relationships to disclose. Guest Laurie Dornbrand has no relationships to disclose. Bernie Lo discloses being an Honorarium Recipient and consultant for Takeda starting on 01/23/2024. And that changed in 1969 I think the first advanced directive was created by Luis Kutner.

Family 112

Family Families Patient-Centered IT 112

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . 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.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 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

MAY 4, 2023

It is really difficult for the patients and the families. Part of that, as you’re alluding to, Eric, is this relationship with authority and with rules and word association, teenage rebellion. Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team. It’s very fraught.

IT 83

IT Family Families Illness 83

GeriPal

FEBRUARY 15, 2024

Panelists Carmen Quatman and Katie Quatman-Yates have no relationships to disclose. 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. Welcome, Katie, to the GeriPal podcast. Katie: Thanks for the opportunity. Katie: Awesome.

Community 114

Community Transportation IT PCP 114

GeriPal

JUNE 15, 2023

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. Is there a true relationship with that? So over fitting just means that you found a relationship in your data that is not going to be generalizable to other people. Alex: Go ahead Matt.

IT 99

IT Patient-Centered Patients Healthcare 99

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

NOVEMBER 21, 2024

But if we’re going to have a family meeting, that’s a different circumstance. 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. So help serves and hinders in everybody.

Illness 125

Illness IT Patient-Centered Patients 125

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

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

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?

Community 115

Community IT Relationship Healthcare 115

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.

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

JANUARY 20, 2023

Jasmine: It’s an imaginative love story that deconstructs age through an intergenerational friend relationship. And yet nursing home residents and their families and the rest of us somehow are supposed to buy into this idea that we can’t get enough staff, so it’s okay to give them poor care. Eric: Can I ask why?

Finance 95

Finance Board-Certified IT Provider 95

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. I loved the relationship that we developed and the fun we had.

IT 104

IT Patient-Centered Family Families 104

GeriPal

APRIL 28, 2022

Because just like in the bedside space, if you are using humor in a way that builds bonds and relationships with the patient can be really beautiful, and normalizing. Here’s another clinician saying, “I ignored a patient’s tears and gave a speech about cardiac physiology during a family meeting.” Eric: Yeah.

IT 145

IT Hospital Patients Illness 145

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. But then recognizing that our relationships impact our health even outside the context of stress.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

DECEMBER 14, 2023

It’s the clinicians on the rounding team, yes, but also the multidisciplinary team is really important, how they support the patient, the family, the doctors, the nurses, but also how the broader institutional structures such as ethics committees, et cetera, how they support. Is that right too?

Hospital 125

Hospital IT Patient-Centered Patients 125

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 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. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. John: Yeah.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JANUARY 18, 2024

Panelists Katie Fitzgerald Jones and Jessica Merlin have no relationships to disclose. Have you had a family history of substance use disorder? Even if the cancer gets cured, they’re not going to become their buprenorphine prescriber, the palliative care consultant. And they ask questions like, have you used substances?

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

MARCH 6, 2025

Michael’s Hospital in the Department of Family and Community Medicine. By the time he got into us, the tumor grew, he had experienced, he was experiencing significant pain and so trauma, informed care and building a relationship with him was such a big part of the care. Naheed, welcome to the GeriPal Podcast.

Healthcare 100

Healthcare IT Community Illness 100

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

DECEMBER 5, 2024

So I think just as much as we focus on the science and the evidence, it’s important to think about the art of how we apply that to people and the relationships and all of the great fun stuff, the stories that unfold in the exam room alongside the science itself. Eric 04:44 Yeah. And I gotta ask Emily, is that why you started Nocturnist?

IT 107

IT Community Patients Family 107

GeriPal

JANUARY 11, 2024

** Claim your CME credit for EP293 “What’s Up With MAID in Canada” [link] Note : If you have not already registered for CME, you can register here [link] For more info on the CME credit, go to [link] Disclosures: Moderators Drs Widera and Smith have no relationships to disclose. But that was separate from MAID.

Illness 144

Illness IT Medical Provider 144

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. Widera and Smith have no relationships to disclose. But she didn’t die. She had grandchildren.

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. It’s about establishing a relationship and rapport.

Patient-Centered 119

Patient-Centered IT Patients Hospital 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.” Widera and Smith have no relationships to disclose.

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

Widera and Smith have no relationships to disclose. Guest Betty Ferrell has no relationships to disclose. He is a palliative care physician at the Durham VA Medical Center in Duke and blogs on Substack at Notes from a Family Meeting. So this, I think we had three or four consults. Josh, welcome back to GeriPal.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

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

JULY 25, 2024

Widera and Smith have no relationships to disclose. Guests Kara Bischoff, James Deardorff, and Elizabeth Lilley have no relationships to disclose. Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. And since starting the clinic, median time for consult to death was. Alex 10:40 Wow.

Family 106

Family Families Patient-Centered IT 106

GeriPal

APRIL 18, 2024

I wonder if you could suggest an empathetic conversation that I could have with her that would not sugarcoat the idea that she has cancer, but do it in the most supportive possible way, and taking into account that she’s got a family and she’s got young kids?” And then, this little mini consultant. ” Alex: Wow.

IT 139

IT Electronics Patients Healthcare 139