GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. Well, I think it was from a place of serious frustration that Hsien and I both felt in our careers that we had spent decades between us trying to change the healthcare system. AMA PRA Category 1 credit(s) ™.

Education 127

Education IT Illness Healthcare 127

GeriPal

JUNE 19, 2025

Alex 00:41 And we’re delighted to welcome Noelle Marie Javier, who goes by “she” “her” and is a geriatrician and palliative care doc professor, newly minted – c ongratulations – And a clinician educator at Mount Sinai in New York City. To note that I am an individual who goes through this world. And we also need it.

Individual 81

Individual Community IT Chronic Condition 81

GeriPal

JULY 21, 2022

That’s where it really gets to this individual risks and balances, individual situation. Eric: But before we jump into talking to your patients about driving retirement cessation, let’s talk about what is the role of the healthcare professional in this at all? Alex: Yeah. Is this our role? Emmy: Yeah.

IT 102

IT Family Families Diagnosis 102

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. AMA PRA Category 1 credit(s) ™. Who do we have with us today?

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. Yes, over diagnosed in older adults are about right.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

SEPTEMBER 21, 2023

I started going to the literature and I noticed that communities of color, those with the Hispanic background, Black individuals were disproportionately impacted by dementia, and I couldn’t believe it. I think, again, it’s the person’s individual, their preference. Alex: Yeah, I like that approach too.

Community 128

Community Family Families IT 128

GeriPal

AUGUST 17, 2023

So what is the role of individuals like geriatricians in prescribing amyloid antibodies and caring for individuals who are receiving them? And I do think geriatricians need to as individuals make that decision, largely based on their comfort with the diagnostics and the specifics of the therapeutics. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. It’s used a lot in the education world. And that’s something we have to just think about.

IT 102

IT Families Family Clinic 102

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? But these tests were never designed to diagnose. Does a good history matter anymore?

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

APRIL 13, 2023

And so I began to think about the training that I had and that there was no mental health condition that was diagnosed. 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. In fact from the time he was diagnosed, he passed away within two and a half weeks.

IT 99

IT Community Patient-Centered Medical 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. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes.

Patient-Centered 52

Patient-Centered Complication IT Patients 52

GeriPal

APRIL 3, 2025

Annie 02:31 So if you go to the A G S meeting every year, you know that this group of three individuals comprises the AGS literature update. But in spite of that, it is a lot of work for three individuals to pull all this together. So that this is not something that might affect the individual clinician patient decision.

IT 64

IT Hospital Screening Patients 64

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. It’s baked into people’s belief systems, who ultimately make laws and make policies, and it can influence healthcare. It can influence education systems.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

APRIL 14, 2022

And I remember being there and there was a patient who had seen inpatient and then subsequently outpatient who was so thankful in the weirdest in just this irrational way for having been diagnosed with liver cancer. Janet: It was this young man. He was in his mid twenties. And it started off with Tylenol then it went to low dose morphine.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

APRIL 4, 2024

She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. I do think that some of the basics, like making sure that we’re updating the surrogate, which require us to find the surrogate is vital and something that we should educate folks about.

Family 112

Family Families Patient-Centered IT 112

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 113

IT Provider Patients Families 113

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is Eric Widera. Eric: Lynn or Anne?

Family 97

Family Families Patient-Centered IT 97

GeriPal

JANUARY 11, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 7, 2024

It sets space between us and the individuals we’re trying to take care of. I think that consistency of what is the expectation of our roles is crucial in a lot of ways, but that role is determined by the individuals we’re serving. I think the market and others will determine those individuals and who they work with.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JUNE 23, 2022

If you know that there’s a group that you don’t treat even after they’re diagnosed, it causes anxiety, but you’re not causing them harms from treatment. So I’m actually interested in also trying to help women who’ve been diagnosed figure out what to do too. Meanwhile, there is risk to the procedure.

Screening 99

Screening PCP PCP IT 99

GeriPal

JULY 28, 2022

And as a resident, I just was drawn, similar to many oncology clinicians and fellows, to just be traumatic and difficult experience of patients with blood cancers during prolonged and intense hospitalizations, where they experience a lot of physical symptoms, emotional trauma related to the diagnoses. Alex: Okay. What year did it come out?

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 27, 2025

For those individuals, how do you think about that? So let’s say a patient who has lung cancer, relatively newly diagnosed, has a long history of substance use disorder, had been taking methadone as an outpatient, and now has this pain. Sach 17:32 For me, it’s our first line opioid. You know the case.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

OCTOBER 3, 2024

They had triple diagnoses, often life threatening illness, but also mental illness and usually some kind of addiction. It’s put its emphasis much more on educational work, which is fantastic. I cracked myself in my head of these individuals. We didn’t honestly have much more of a plan than that.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

SEPTEMBER 19, 2024

So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 16:38 So everybody was diagnosed with an advanced lung cancer sometime in the last twelve weeks and then they were randomized. So it even changed over the course of the study. So you’re seeing.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

Those are all things that could dramatically be a major health shock for an individual. May not even know that the patient has dementia, or they might think that, but it’s not been diagnosed. Maybe you lose your home or you get evicted from where you’re living or you’re suddenly, no, you no longer have stable housing.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JULY 6, 2023

It could be in housing, it could be a standalone senior center, home delivered meals, nutrition counseling and nutrition education done by registered dieticians. I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. To Susan’s point.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

But most people with dementia are initially diagnosed and medically managed in primary care, and they really desire clinicians to initiate these conversations but there are a number of really important barriers for these conversations taking place. There’s also education that goes with it, educating, like, what does that mean?

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

MAY 1, 2025

One in 10 people with newly diagnosed HIV is an older adult. And over that first 15 years, which was a very difficult time when there was no treatment at all available, everybody died and usually within months or a year or two of when they were diagnosed. And I also read that 1 out of 10 newly diagnosed HIV cases are in older adults.

Primary Care 94

Primary Care IT Clinic Provider 94

GeriPal

DECEMBER 21, 2023

This model will give participating programs a per-member-per-month payment to offer care management, care coordination, and other services such as caregiver training, disease education, and respite. I had the tenacity and education to try to figure this out. They could have diagnosed him earlier. I had a supportive spouse.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

SEPTEMBER 14, 2023

The patients that, I think, most benefited from it were those individuals who, as I said, maybe, had a pneumonia, and needed IV antibiotics, but wanted to do that… If they could get better in the comfort of their own homes, that were not interested in passing away in the hospital. You can broaden the scope of diagnoses.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 16, 2024

Eric Widera reminds us of the history of the Goldwater Act created by the American Psychological Association in the 1960s which states that psychiatrists should refrain from diagnosing public figures, and the American Medical Association code of ethics which likewise discourages armchair diagnosis (rule established in 2017).

Diagnosis 141

Diagnosis IT Diagnose Physicals 141