GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. So cachexia, I would put it involuntary weight loss is the number one way to diagnose it.

Illness 133

Illness Patient-Centered Patients IT 133

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. Should you stop at “no?” Anne Kelly: Hi there. Nice to be here. Eric: Lynn or Anne?

Families 97

Families Family Patient-Centered IT 97

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Love to talk about also in the serious illness population. Eric: Yeah. Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. This is my early father’s day gift from the family. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Transcript. Eric: Yeah.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. And so when you have that, that’s so good for the family. That’s so good for us.

IT 102

IT Family Families Clinic 102

GeriPal

JUNE 9, 2022

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. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. It’s what I know.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. Alex: And Sammy Winemaker, who’s a palliative care physician and Associate Clinical Professor at McMaster University in the Department of Family Medicine, Division of Palliative Care. Sammy: Thank you so much.

Education 127

Education IT Illness Healthcare 127

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. If they didn’t do it all by themselves, they talked to the family and it was a conversation, but also there wasn’t a whole lot that doctors can do then. What words to use?

Family 112

Family Families Patient-Centered IT 112

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me. Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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. Summary Transcript CME Summary It is a battle royale on this weeks GeriPal podcast. But watch out!

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JUNE 15, 2023

And this case has been worked out the best in terms of the artificial intelligence suggesting diagnoses the clinician may have missed. Because the in serious illness care and care for older adults, their care is often very complex. And I think that’s where it gets really interesting from the standpoint of ethics. Alex: Mm-hmm.

IT 99

IT Patient-Centered Patients Healthcare 99

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.

Illness 144

Illness IT Medical Provider 144

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.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

AUGUST 25, 2022

And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices. It’s really a pretty traumatic experience for a lot of patients and families. AlexSmithMD. Transcript. Melissa: Sure.

Family 106

Family Families IT Patients 106

GeriPal

SEPTEMBER 21, 2023

Fayron: I think I was interested in family caregiving early on because I had it in my family, but it wasn’t until my postdoc days when I was writing my application that I needed to narrow it down. Those are the things that Black family caregivers that I’ve been working with go through. Fayron: Yeah.

Community 128

Community Family Families IT 128

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.

Provider 117

Provider Illness IT Healthcare 117

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

MARCH 24, 2023

2021 Association of Hospice Profit Status With Family Caregivers’ Reported Care Experiences. I’m very proud of the work that we do every day and we take care of patients and families no matter where they live or who they are to help them meet their end of life goals. How do we make this work for patients and families?

IT 113

IT Provider Patients Family 113

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.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. What feelings do we have toward the patient and toward their families? And also the whole potential psychiatric diagnoses. How did you react? Afterwards, I thought there must be a better way.

Patients 109

Patients IT Family Families 109

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

AUGUST 8, 2024

We cover a wide range on this topic, weaving in our own stories of loss with Thomas’s experiences, stories, and poems from years of caring for families after their loved one’s have died. And so the, just means that we want to minimalize any bother that attends the death in the family. Here it’s done as a form of disappearance.

IT 124

IT Family Families Relationship 124

GeriPal

FEBRUARY 9, 2023

For example, we spend the first half talking about a RCT simulation study of clinician verbal and non-verbal communication with a seriously ill patient with cancer. And if the doctors still come up with different diagnoses or perceptions of what’s happening with the patient and or treatment plans, that’s all on them.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

OCTOBER 3, 2024

I wonder if you could say a little bit more about the meta Institute in particular and what it is that clinicians today can do to learn, to be more present and learn about the need to be thoughtful and compassionate in the care that they provide people with serious illness. Frank 08:43 Well, briefly. Where can they go? That was it.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

FEBRUARY 2, 2024

And PAIR stands for the Palliative and Advanced Illness Research Center. And, of course, this is what families of patients undergoing palliative care go through. So, Alex, imagine you’re a seriously-ill hospitalized patient and I’m your doctor, unluckily for you. Scott, welcome back to GeriPal.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

OCTOBER 27, 2022

Someone who’s healthy in their 60s and just got diagnosed with diabetes, yeah, they might benefit, if they have a very long life expectancy, to prevent that decline in kidney function. So we wanted to create a model that’s going to reflect that sort of risk and what it also means for their families and financial decisions.

IT 95

IT Clinic Screening Patients 95

GeriPal

JUNE 26, 2025

I think part of this does stem from a clinical experience and also some of the theoretical models that have evolved around serious illness, you know, to think specifically about dementia. And so trying to think a little bit more about what could be driving some of those alterations in the trajectory for all kinds of serious illness.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JUNE 6, 2024

Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. So we got a lot to cover on sexuality, sexual health, and serious illness. I think this is a topic we don’t talk about as much in the context of serious illness. Don, welcome to GeriPal. Don 01:11 Thank you so much.

Illness 130

Illness IT Physicals Patients 130

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. Alex 12:36 And most of our listeners are like clinician, practicing clinicians caring for older adults, people with serious illness. I guess we would say that most trials are superiority trials.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

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. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Family 106

Family Families Patient-Centered IT 106

GeriPal

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. And I have a long interest in identifying family caregivers and supporting them in care delivery. Eric 06:26 Great.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

APRIL 21, 2022

Poetry helps us grapple with our own experiences of illness. Redwing: So I grew up in a pretty intellectual family, but my brother and sister were six and 10 years older than me, and they were always feeding me literature and poetry. To let it go. . Or as in Mark Nepo’s poem Adrift, I am so sad and everything is beautiful. Eric: Yeah?

Patient-Centered 93

Patient-Centered IT Community Illness 93

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 Provider Clinic 94

GeriPal

DECEMBER 1, 2023

Heather: I’m requesting the song Don’t You Forget About Me, which is one of the things that I think matters most to patients and families living with Alzheimer’s disease. That’s in my view as analogous as to any other illness. You need the plaques to have that illness. Eric: Wonderful. Jason: Oh, well.

IT 115

IT Clinic Illness Hypertension 115

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. Alex 28:22 That’s not in the vital talk, serious illness, communication.

IT 113

IT Family Families Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

If you are interested in learning more and meeting a community of folks interested in hospital-at-home, check out the hospital-at-home user group at hahusersgroup.org or some of these publications: Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. 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). Sorry, Ken.

Diagnosis 141

Diagnosis Diagnose IT Physicals 141