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? Listen in to learn more!

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. We’re going to be talking about new research in psilocybin in serious illness. Vincent’s Hospital in Melbourne, Australia. This is Eric Widera.

Illness 106

Illness IT Patient-Centered Patients 106

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. Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Illness 135

Illness Patient-Centered Screening IT 135

GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Katie, before we jump into the topic of buprenorphine in serious illness, what’s the song request?

Illness 102

Illness Patient-Centered IT Nurse Practitioner 102

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. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

Hospital 124

Hospital IT Patient-Centered Patients 124

GeriPal

JUNE 12, 2025

I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. So you have the consultation. Sometimes individuals have lung tumors that make it difficult for them to breathe. There really was very little.

Patient-Centered 101

Patient-Centered Referral Patients IT 101

GeriPal

SEPTEMBER 22, 2022

Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. One bump is just the classic pitfalls we often talk about in serious illness communication: being very jargony, very information focused, and just providing information. It flows very well. Josh: Mm-hmm.

Illness 101

Illness IT Patient-Centered Patients 101

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. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 121

Patient-Centered IT Illness Patients 121

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. Why it’s such a natural way to explain the condition of someone with an acute critical illness that’s threatening their life. This is Eric Widera.

Illness 135

Illness IT Patient-Centered Families 135

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? For more details, please click here. (AP AP Recruit Job No.

Illness 100

Illness Mental Health IT Patient-Centered 100

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today. Eric 05:03 Nice.

IT 131

IT Illness Families Family 131

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. When should people get palliative care? What is a pragmatic trial ?

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Bennett, C.R., Schilling, L., Doorenbos, A. PMID: 26701962.

Patient-Centered 114

Patient-Centered Illness Healthcare IT 114

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast.

Patient-Centered 131

Patient-Centered Hospital Patients IT 131

GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? And then we were involved, palliative care was consulted when the patient was really sick and decompensating in the ICU. That’s a huge amount of news all at once. This is Eric Widera.

Families 97

Families Family Patient-Centered IT 97

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 114

Consulting Patient-Centered IT Patients 114

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. Many were community hospitals. Participants were critically ill and intubated. What is sludge? What to make of that?

Patient-Centered 115

Patient-Centered Hospital IT Illness 115

GeriPal

DECEMBER 15, 2022

So during the dissertation, that was a method for my PhD research and that’s related to… I was learning about African American elders experiences of psych-social-spiritual healing and serious illness. Been in the hospital four times, vented, been told the story to her family, she won’t live.

IT 104

IT Patient-Centered Healthcare Illness 104

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 104

Telehealth Patient-Centered IT Patients 104

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Eric 00:51 So we’re gonna be talking about caring for people with serious illness and substance abuse. Who has a song request for Alex before we talk about substance use disorder and serious illness?

Patients 71

Patients Clinic Patient-Centered Illness 71

PEMBlog

MARCH 27, 2024

She aims to become a physician-scientist in pediatrics and medical genetics, engaging in bench-to-bedside research that utilizes multi-omics-based approaches to provide a molecular diagnosis and support personalized care for individuals with suspected rare genetic diseases and their families. References Jeanmonod R, Asuka E, Jeanmonod D.

Consulting 59

Consulting Individual Families Family 59

GeriPal

JUNE 30, 2022

Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. And she was rushed to the hospital. Did I get that right? Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. 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.

Families 111

Families Family Patient-Centered IT 111

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. So less than six months to live.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Eric: Yeah.

IT 83

IT Families Family Illness 83

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. 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. His story, which he shares on todays podcast, is remarkable.

Healthcare 99

Healthcare IT Community Illness 99

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. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

Complication 52

Complication Patient-Centered IT Patients 52

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.

Patient-Centered 76

Patient-Centered IT Hospital Patients 76

GeriPal

FEBRUARY 13, 2025

You did a rural tele-palliative care consultation study. Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. And so the video consult was what became the mode. NCP guideline, standard consultation.

Consulting 62

Consulting Community Patient-Centered Families 62

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. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended? Yael 30:29 Exactly.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

GeriPal

JUNE 5, 2025

nursing homes grapple with serious illnesses, and roughly half experience dementia. So, how can we improve palliative care for individuals in nursing homes? The reason that you’re in a nursing home is because you have some mix of serious illness and multimorbidity, usually functional impairments.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. by Kearney. Lovely to be here.

IT 103

IT Patient-Centered Families Family 103

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. On the other side, there’s another group that thinks, you know what?

IT 112

IT Provider Patients Families 112

GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. And we actually found that when she was really terminally ill, she had a cancer that was potentially curable if treated early, it was not.

Community 114

Community IT Relationship Healthcare 114

GeriPal

APRIL 24, 2025

If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Do elements of care that are often administered to seriously ill patients count? Eric 06:58 It could be CPR in an individual with metastatic cancer in the icu. Think vitamins. Think chemo. Animal studies?

Patient-Centered 76

Patient-Centered IT Patients Illness 76

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. But now we have older people dying of older people illnesses. When they built a new prison hospital in Stockton, the dialysis went there. Michele: Yep.

Families 131

Families Family IT Community 131

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. And so really thinking about people’s individual experiences, what might help for them.

IT 98

IT Community Patient-Centered Medical 98