Rao Doctor

FEBRUARY 27, 2025

F (37°C), although this can vary slightly among individuals and throughout the day. Understanding the fundamental aspects of fever is crucial for effective management and treatment. Each pattern provides diagnostic insight, leading to more effective management of the patient’s condition. What does fever do?

Management 100

Management Diagnosis Illness Medical 100

GeriPal

MARCH 14, 2024

We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. Eric: And for those individuals, do we know anything? This is Eric Widera.

IT 124

IT Hospital Patient-Centered Individual 124

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. And yet we’re also in a different place in diabetes monitoring and management. Eric: And you can probably tell already, the topic at hand is diabetes management in late life.

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

OCTOBER 13, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes. Devika: Thank You.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JUNE 12, 2025

So you have the consultation. But two, a very close relationship with potentially the palliative care physician or the individual who’s Sort of managing their pain, because the simulation itself can be 20 to 30 minutes of lying in that specific treatment position. Procedure as well as the treatments. And was that okay?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Rao Doctor

APRIL 3, 2025

When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Fever in infants under three months, a fever lasting more than three days, or a fever in individuals with weakened immune systems should be promptly addressed by a doctor for appropriate management and treatment.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 19, 2025

Noelle Marie 01:24 I think it really speaks a lot to my own personal journey and I’m pretty sure a lot of trans and gender diverse individuals also resonate with and it really speaks about our transition, celebrating our authentic selves, how society views us and how we view ourselves when we stand in front of a mirror.

Individual 85

Individual Community IT Chronic Condition 85

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. However, there are “Red Flag” symptoms that require urgent evaluation and management.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

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

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

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. Maybe we’ll get to talking about that today. Jessie: Thank you.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

JANUARY 25, 2024

It was around helping communication, and really focused on our nursing manual, and particularly around these guidelines for assessing and managing symptoms. I’d be operating at the top of what I’m capable of doing, to provide really tailored and individualized care for my patients and their care partners, where they are.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

JUNE 5, 2025

So, how can we improve palliative care for individuals in nursing homes? And so I tried to get her actually to pain management, and I couldn’t. Pain management wouldn’t come to the facility, and she was bedbound. And so it really got me interested in how we improve symptom management. Cognitive impairment.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Is the sort of task to manage. I mean, how do you negotiate that with the oncologist who is the one who consulted you, by the way, Eric, who does that go to?

IT 132

IT Illness Families Family 132

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 15, 2024

But that was a small pot of money and we went to first call a handy person, it was going to be $500 for a consultation, let alone the installation, and we were like, “This is absolutely cost-prohibitive. Same thing with kind of medication management. All of these are factors that are on the individual level.

Community 114

Community Transportation IT PCP 114

GeriPal

OCTOBER 26, 2023

In recent years, pressures to decrease hospital length of stay and increase throughput, the rate at which patients are moved in and out of the system has contributed to a culture in many acute care environments where physical therapy functions primarily as a consultation service for discharge planning. Ann: My palliative care doc is great.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

FEBRUARY 27, 2025

Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness – should we/can we split up the once daily dosing to achieve better pain control? When to consider bupenorphine vs methadone? They’re often angry.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

MAY 8, 2025

And those of us who work in palliative care are more familiar with the 5ht3 receptor, which we use for nausea management. Due to this sense of allostatic overload, like you’re just overwhelmed and you don’t have the resources, the self efficacy or the self esteem to manage it. So 5ht2 was. Almost all.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

APRIL 14, 2022

Management of chronic pain in the elderly: focus on transdermal buprenorphine. And how am I going to manage their pain? And then part of our role as folks in palliative care who as Katie mentioned, really try to help folks manage distress around serious illness. Two great videos on buprenorphine initiation. Transcript.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. We talk a lot about people being unhoused, which I think takes the blame away from the individual and kind of de. Naheed 20:04 And you know, the key to this conversation is not to put the onus on individuals.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes. Devika: Thank You.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. Eric: And what do we know about the outcomes of individuals getting these procedures, especially those with cognitive issues and dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

DECEMBER 8, 2022

Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So those questions we ask when we’re doing a palliative care consult. ” So lo and behold, that’s how I met Thor. Just go to www.geripal.org.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MAY 4, 2023

How do we see each of you as individuals who are having your own struggles? So you get to what the person individually might need around them, and last, how are you seeing this experience? Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team. All of a sudden, I was like, wow.

IT 83

IT Families Family Illness 83

GeriPal

DECEMBER 14, 2023

And it was amazing just seeing the differences in how end-of-life care is managed at those three institutions, which were all a subway right away from each other. For example, here’s a quote from somebody at a high intensity hospital, “There’s a culture from the top of the healthcare system down. Liz: Right.

Hospital 125

Hospital IT Patient-Centered Patients 125

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. It was like this patient is on hospice and call the case manager to figure out how the patient ended up here. So that’s great. No, no, no.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MARCH 24, 2023

I think some individuals thought there was cherry-picking of stories that made it seem like hospice is this bad thing, that it’s taking advantage of vulnerable individuals and it didn’t talk enough about the good things that hospice does. How many patients is my hospice nurse case manager responsible for on any given day?

IT 113

IT Provider Patients Families 113

GeriPal

APRIL 13, 2023

I think some of that is from some of my thinking about maybe what I can potentially think about with the individual to support them. ” Eric: And I remember from my last podcast, Ashwin, it was about individualizing our approach to loneliness too, right? I would say that I primarily skew my questioning towards isolation.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

DECEMBER 15, 2022

Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So those questions we ask when we’re doing a palliative care consult. ” So lo and behold, that’s how I met Thor.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

MARCH 13, 2025

Sue 13:15 There was 12 beds, there was a head nurse for home care, There was only one head nurse doing that and a consult nurse that was seeing patients on other wards that were a likely admission choice. A good prescriber, a good symptom control manager. Sue 13:11 The Royal Victoria Hospital, Montreal. Eric 13:14 Okay. Balfour amount.

IT 104

IT Patient-Centered Families Family 104

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. We tested two different nudges individually and then we combined them. What is sludge? I highly encourage you. Kate 13:59 What did we do?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

SEPTEMBER 22, 2022

And that’s not the information that we’re looking for as much when we’re the palliative care consult team. And I find that sometimes when I’m consulted into really difficult situations… Well, I mean the nature of inpatient medicine is that patients and their families don’t often know their doctors.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. Eric 12:11 And we consult psychiatry. Oh, yeah, yeah.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JANUARY 20, 2023

If you own and operate a nursing home and you’re taking people in, and you’re admitting new residents, what’s their accountability for how they manage compensation and quality delivery? I’m the project manager, so my job’s to zoom in. What are they accountable for? Tell me about that. Eric: Great.

Finance 95

Finance Board-Certified IT Provider 95

GeriPal

JANUARY 11, 2024

You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). And so in that context, knowing that there was going to be some evolution of policy in this area, that’s how I got involved consulting with members, trying to understand the situation better, that type of thing.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. But from what we read was much better as century back, is in communities manage their own affairs. What do you think about that?

Community 115

Community IT Relationship Healthcare 115