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. Panelists Kate Courtright and Scott Halpern have no relationships to disclose. and consulting for Papa Health.

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Consulting Hospital Patient-Centered IT 122

GeriPal

JANUARY 18, 2024

Panelists Katie Fitzgerald Jones and Jessica Merlin have no relationships to disclose. Panelists Katie Fitzgerald Jones and Jessica Merlin have no relationships to disclose. Eric: And Alex, we’re going to be talking about substance use disorder and serious illness and aging, with three amazing experts. This is Eric Widera.

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Illness Patient-Centered Screening Clinic 137

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 102

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 Families Family 133

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 Families 136

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.

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Families Family Patient-Centered IT 98

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. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. There has to be more than this.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

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 106

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 116

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. What words to use? Is the POLST useful? Under what circumstances? Should we abandon the term, “comfort measures?”

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Families Family Patient-Centered IT 113

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 Families Family Illness 83

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?

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

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 106

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. Is there a true relationship with that? Matt: I think you’re also… Go ahead.

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IT Patient-Centered Patients Healthcare 100

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

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 82

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 Families 64

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 119

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.

Patient-Centered 79

Patient-Centered IT Patients Illness 79

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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Community IT Relationship Healthcare 116

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

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. 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. Nathan: Hello, excited to be here.

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IT Hospital Patients Illness 145

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.

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IT Patient-Centered Families Family 105

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 102

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 126

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.

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IT Community Patient-Centered Medical 100

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

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Patient-Centered IT Hospital Patients 78

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?

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IT Community Patients Families 108

GeriPal

SEPTEMBER 5, 2024

You know, she would have had 90 really good years, and she would have just gone into a coma with no blood pressure and died, you know, with, like, a day and a half of illness. She entertained her family. Thanksgiving’s coming up, you’re having your family, Christmas coming up. But she didn’t die.

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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. If they don’t, they don’t. Is this superior to that?

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

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.

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Patient-Centered IT Patients Consulting 129

GeriPal

APRIL 26, 2024

Summary Transcript Summary As Betty Ferrell says on our podcast today, nurses play an essential role in care of people with serious illness. Widera and Smith have no relationships to disclose. Guest Betty Ferrell has no relationships to disclose. So this, I think we had three or four consults. Doing home care?

Patient-Centered 121

Patient-Centered IT Patients Consulting 121

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. Widera and Smith have no relationships to disclose. Guests Kara Bischoff, James Deardorff, and Elizabeth Lilley have no relationships to disclose.

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Families Family Patient-Centered Patients 108

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. Health care professionals are human, and as humans we experience loss both in and out of work. Turns out, it’s maybe not. She was homeless. Eric: Yeah.

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Healthcare Professional Healthcare IT Relationship 103

GeriPal

FEBRUARY 2, 2023

For example, is reluctance to take on more responsibility at work or relocate because you feel inadequate or is it because of genuine concern about the impact on your family? ” And it’s about her relationship to her therapist at the same time, she’s also a therapist, so it’s about the people that she saw in therapy.

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IT Medical Student Medical Families 105

GeriPal

AUGUST 22, 2024

Patients families want to know whether their loved one has died. And one would be when care is continuing a case where people believe that the patients died, or oftentimes, this is also a source of controversy between families and clinicians. And I think maybe we could list them all. That’s one key interested party.

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IT Families Family Patient-Centered 115

GeriPal

DECEMBER 12, 2024

Ill end this intro with a quote from Deb Grady in an editors commentary to our thought piece in JAMA Internal Medicine about this topic: Voice technology that creates a searchable database of patients every encounter with a health care professional? You basically don’t even ask the family, you just stop the bleeding.

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Patient-Centered IT Patients Healthcare 110