GeriPal

MAY 5, 2022

And one of the parts of that was actually doing physicals for the students and putting them in job placements. And so often we get consulted by teams that say, “I have this older patient and they’re pretty isolated and I think they have dementia. I wonder if you could engage their family in the goals of care discussion.”

IT 102

IT Screening Hospital Clinic 102

GeriPal

OCTOBER 10, 2024

social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. For instance, a family meeting or an update or communication with families. So, for instance, I do a psychosocial screen, I do a physical screen, I do screens in all the other domains.

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. 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

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.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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

JANUARY 25, 2024

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. I was really passionate about helping the people and also their families. Eric: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. 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.

Community 114

Community Transportation IT PCP 114

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

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

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.

IT 128

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. 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?

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team.

IT 83

IT Family Families Illness 83

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

JUNE 15, 2023

I actually like reading books and the physical,” and what the internet 2.0 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: We have seen pilot level studies, interventions like that one to do clinical ethics consultation.

IT 99

IT Patient-Centered Patients Healthcare 99

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. Gender expression is your physical outward manifestation of how you express your gender identity.

Individual 85

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. In many cases, the families were the victims of the crime. And we’ve really tried to serve that hospice mission of serving the patient and the family.

Family 132

Family Families IT Community 132

GeriPal

APRIL 28, 2022

Here’s another clinician saying, “I ignored a patient’s tears and gave a speech about cardiac physiology during a family meeting.” I was just thinking back to yesterday, we were in a family meeting. Did they ask for a consult?” That’s scare tactics. Eric: Yeah. Somebody asked the question.

IT 145

IT Hospital Patients Illness 145

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

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

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

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.

Patients 109

Patients IT Family Families 109

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 10, 2022

The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. We found their physical environment was drastically different; where those with low feeding tube rates had really a rather beautiful physical environment. Archives of Internal Medicine 2010. Rehabbed to Death. What might be contributing?”

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MAY 12, 2022

What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. Raj: 40 years later in 2018, they got together at Astana, the then capital of Kazakhstan, and brought out another resolution, which ask member countries to give control over healthcare to the community. Healthcare industry cannot do it.

Community 115

Community IT Relationship Healthcare 115

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. That was the patient and the family were of equal importance.

IT 104

IT Patient-Centered Family Families 104

GeriPal

MARCH 6, 2025

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. 80% died exactly where they wanted to and 83% were reconnected to family or friends through a psychosocial support system that we put into place.

Healthcare 100

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.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

JANUARY 11, 2024

What happened is that firstly, in terms of my clinical background, my background is psycho-oncology, so that’s working with patients with cancer and their families, including when they’re going through periods. So being well and also potentially periods of dying. But that was separate from MAID. Eric: Thank you Bill.

Illness 144

Illness IT Medical Provider 144

GeriPal

DECEMBER 19, 2024

It’s one of the core things that we think about palliative care is you got the physical, psychological, social and spiritual symptoms. 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? Eric 12:11 And we consult psychiatry.

Illness 101

Illness Mental Health IT Patient-Centered 101

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. It’s not just about physical symptom management.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. So how physically active the patient is, how much time they spend awake, how much they’re eating, how much care they need, that type of thing. And since starting the clinic, median time for consult to death was. Eric 10:44 No, all consults.

Family 106

Family Families Patient-Centered IT 106

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

FEBRUARY 24, 2022

And it was really good for my mental and physical… Physical health, obviously, but mental health really. We see our patients and our families throughout the illness trajectory into the hospital. It’s hard for your family to know. It’s part of our family mythology. We see them struggle, right?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

JULY 20, 2023

And so I’m not sure if this is true for Joe or for Brooke, but even before the pandemic in our practice here, we saw somewhere around 40 to 50% of our patients via telemedicine anyway, because we have a catchment area of patients who live very far away, many of whom have a lot of physical disability and other limitations to coming in person.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73