The Clinical Problem Solvers

APRIL 24, 2025

Simon is a pediatric addiction medicine psychiatrist at Boston Children’s Hospital; an assistant professor in psychiatry at Harvard Medical School; a recent Commonwealth Fund fellow in health policy at Harvard University; and the medical director of Wayside Youth & Family Support Network.  References 1. Benton TD , Boyd RC , Njoroge WF.

Mental Health 52

Mental Health Community Hospital Appointment 52

Family Physicians of Greeley

MAY 17, 2023

If you struggle with sleep difficulties, consider implementing relaxation techniques or consulting with a healthcare professional. Remember, everyone’s journey is unique, and it’s important to be patient and kind to yourself. By doing so, you can lead a happier, more fulfilling life.

Mental Health 40

Mental Health Physicals Healthcare Professional Relationship 40

GeriPal

APRIL 27, 2023

Attendee 11: I am hopeful that the model of care that we deliver is what our patients and their caregivers want, need and deserve. Attendee 16: Not being able to be involved as early as we all would like to be in the course of any patient’s trajectory of their illness. Attendee 18: The science. Eric: Tell me more.

Specialization 93

Specialization Illness Healthcare Patient-Centered 93

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. Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? How high is too high?

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

DECEMBER 2, 2022

He wrote a book titled “ Psychiatric consultation in long term care ” that has a strengths based approach to staging dementia (how cool is that). She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. Anne: Is there a movement? I love them.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

MAY 5, 2022

So, it’s a critical component if you really want to have conversations about goals of care, you want to have conversations about the types of treatments that the person wishes to have, or doesn’t wish to have, and to really engage the person and the family in these conversation. I’m on palliative care service right now.

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IT Screening Hospital Clinic 102

GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. and consulting for Papa Health. And, of course, this is what families of patients undergoing palliative care go through.

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Consulting Hospital Patient-Centered IT 120

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. Why did you all decide to write an updated book on navigating communication with serious ill patients?

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IT Illness Family Families 132

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” Anne Kelly: Hi there. Nice to be here. Lynn: I do.

Families 97

Families Family Patient-Centered IT 97

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.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

FEBRUARY 16, 2023

Summary Transcript Summary Think about the last time a patient yelled at you in anger. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Ask why: What is underneath the anger for this particular patient? Taking care of the hateful patient.

Patients 109

Patients IT Family Families 109

GeriPal

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. Your research is a lot in this patient population, right? The article we discuss today, also published in JAMA , addresses these two gaps. Big randomized control study that came out. Important implications.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

OCTOBER 10, 2024

And it not only leads to better outcomes for patients, it leads to our better sustainability. For instance, a family meeting or an update or communication with families. And we’ll have a patient with very severe symptoms that are just not responding to the normal treatments. The collaboration is actually the center.

Screening 119

Screening IT Family Families 119

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. Our loves, our triumphs, our failures, our work, our families. . My Life, My Story: VA’s healthcare improvements through deliberate storytelling – YouTube.

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Patient-Centered Illness Healthcare IT 115

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 I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor? Alex 10:41 No, they don’t.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

APRIL 4, 2024

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. Bernie Lo discloses being an Honorarium Recipient and consultant for Takeda starting on 01/23/2024.

Family 112

Family Families Patient-Centered IT 112

GeriPal

JUNE 9, 2022

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. And I practiced both on the palliative care consult team and in the ICU.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

MARCH 28, 2024

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. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. And that’s it. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

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. And that’s how we connected.

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IT Family Families Patient-Centered 128

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

OCTOBER 24, 2024

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? And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. Eloise, welcome to the GeriPal podcast.

Medical 98

Medical IT Patient-Centered Healthcare 98

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

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. Eric: Yeah.

IT 83

IT Family Families Illness 83

GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient. Heather: Sure.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JUNE 5, 2025

Eric 03:25 So we have a lot to talk about, but I’m wondering if we can kind of take a big step back and just talk about the patient population that’s in nursing homes. Connie 06:18 So, I’ve been a clinician working in the nursing home since back in the 80s, and I saw a lot of patients that really needed palliative care.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

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. Healthcare staff were afraid of patients with HIV because there wasn’t clarity on how it was transmitted. Michele: Thank you for having me. Michele: Yep.

Family 132

Family Families IT Community 132

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. Going into patient’s homes was eye opening. Eric: Well, what are the odds that two family members focus on a similar topic and do research together?

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Community Transportation IT PCP 114

GeriPal

SEPTEMBER 22, 2022

Have you ever had that moment when talking to a patient, when you realized that the phrase you just uttered, which you’ve uttered a hundred times before, came out rote and scripted? And in response, the family or patient looked at you like you were from another planet? Summary Transcript Summary. Yeah, I’ve been there too.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

NOVEMBER 21, 2024

Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. You probably haven’t read in a while what that patient encounter was like. Coping is something that we see our patients do. We can ask ourselves, is it serving the patient? How is it serving the patient?

Illness 125

Illness IT Patient-Centered Patients 125

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

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. And so, let’s help them.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

APRIL 14, 2022

Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . So here we go.

Illness 102

Illness Patient-Centered IT Patients 102

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. If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be. Nathan: I do.

IT 145

IT Hospital Patients Illness 145

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. And that’s an ADC of two to three patients a day.

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IT Provider Patients Family 113

GeriPal

OCTOBER 5, 2023

I love this article as it specifically discusses what’s wrong with “ need ” statements and how we can shift our communication and thinking to create space for deliberation about patients’ priorities and the best course of action. So I first want to just say thank you to Ernesto’s family. This is Eric Widera. Sunita: Yes.

Illness 136

Illness IT Patient-Centered Family 136

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.

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Individual Community IT Chronic Condition 85