GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. If you look in the diagnostical statistical manual, right, the sort of handbook for diagnoses, most of the diagnostic criteria are in some important ways kind of arbitrary, right? Brianna 00:41 Thanks. Great to be here.

Illness 129

Illness IT Diagnosis Patient-Centered 129

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. And I would say we weren’t doing training on symptom management, for example.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

OCTOBER 17, 2024

And so, unfortunately, I think for a while, this condition, for many people, isn’t diagnosed until you end up seeing a cardiologist or a heart failure doctor who’s really honed in on this to say, actually, this is a heart failure syndrome. Is your impression that HFpEFde is under diagnosed in older adults? Was it sodium hf?

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

FEBRUARY 22, 2024

They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. Because often what we hear from patients, “I do a lot of pain management research,” but mood comes up in that a lot, is that, “Oh, I don’t want to talk to my doctor about this.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. Does a good history matter anymore?

Primary Care 95

Primary Care Diagnosis Screening IT 95

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. As a nurse case manager in hospice, half of my patients had dementia. And I had a blast playing Take the Money and Run! AlexSmithMD.

Family 106

Family Families IT Patients 106

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

JULY 28, 2022

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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 13, 2024

Alex 00:20 Today we’re delighted and honored to welcome Eduardo Bruera, who is one of the biggest symptom management gurus, if not the biggest symptom management guru in palliative medicine. We have an epidemic of BMI and therefore never use the way the patient looks like to diagnose cachexia. Who do we have with us today?

Illness 133

Illness Patient-Centered Patients IT 133

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 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.

Illness 102

Illness Patient-Centered IT Patients 102

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. I would say though that any healthcare system needs to have a very, we have to have frameworks for how to evaluate this model Eric: Yeah. Alex: Mm-hmm. Alex: Go ahead Matt. I got another use question.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

AUGUST 31, 2023

He spent a long time as hospice medical director and he founded a national model of care that many of our listeners will be familiar with, AIM, which stands for the Advanced Illness Management program, which has influenced CMS policy. That’s what normal means when you’re first diagnosed, wanting to go back to before the illness.

Illness 128

Illness IT Diagnose Medical 128

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. Management, it’s hard. JAMA Health Forum.

IT 113

IT Provider Patients Family 113

GeriPal

AUGUST 17, 2023

We invited three geriatricians and memory care doctors, Nate Chin, Sharon Brangman, and Jason Karlawish, to talk about this question and many others swirling around on how to safely prescribe these drugs and manage patients on them (like what to do about anticoagulation). And we’ve been diagnosing it at Penn.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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. I called my parents, and we talked.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 16, 2023

Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond.

Patients 109

Patients IT Family Families 109

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.

Illness 101

Illness IT Patient-Centered Patients 101

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. John: I am what I am, which is a family practice doctor. ” I think the family would like you to consider how to work with that. That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

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. We examine, we diagnose, we fix. We began this here in Winnipeg.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

JANUARY 11, 2024

You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). What happened is that firstly, in terms of my clinical background, my background is psycho-oncology, so that’s working with patients with cancer and their families, including when they’re going through periods.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 2, 2024

And, of course, this is what families of patients undergoing palliative care go through. Talked about things like pragmatic ways to manage volume, anticipated volume, gave them projections of volume based on enrollment that was going on in usual care, and just really did a lot of palliative care. We did a lot of listening. .”

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

JULY 6, 2023

Administration on Aging connecting you to services for older adults and their families California’s Master Plan for Aging New York’s Master Plan for Aging Transcript Eric: Welcome to the GeriPal Podcast. I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse.

Community 89

Community Nurse Practitioner Provider IT 89

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. It’s not just about physical symptom management.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JULY 25, 2024

So we really wondered, you know, in modern palliative care practice, where we’re seeing patients a lot farther upstream than we used to, and we’re seeing patients with a wider range of diagnoses, we wanted to update, sort of. So it’s not just like the patient or the family, but it’s also the healthcare system.

Family 106

Family Families Patient-Centered Patients 106

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

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. 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.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

DECEMBER 21, 2023

Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.” Malaz: I love it.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

APRIL 21, 2022

Look also for a forthcoming article by Mike and Redwing in Journal of Pain and Symptom Management on poetry as a healing modality, to be published mid May (will add link when out). Redwing: When you’re diagnosed with cancer, the first thing you think about is when you’re going to die. Eric: Like since a little kid?

Patient-Centered 93

Patient-Centered IT Community Illness 93

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. I’ve got the Alzheimer’s that has me needing someone to manage my checkbook. Eric: Wonderful. laughter] Heather: Good point.

IT 115

IT Clinic Illness Hypertension 115

GeriPal

AUGUST 22, 2024

And then another, which was released under the Bush administration by a council with a different sort of philosophical Benton worldview which still managed to come to the same conclusion in support of a brain based definition, death. Patients families want to know whether their loved one has died. That’s one key interested party.

IT 113

IT Family Families Patient-Centered 113

GeriPal

JUNE 6, 2024

And so clearly it matters how you bring up the topic, who brings up the topic, and probably the timing when this comes up for patients and families, just like we think about conversations about illness and prognostic understanding, I wish there was a good prevalent state data on how big this is of a problem in serious illness at large.

Illness 130

Illness IT Physicals Patients 130

GeriPal

SEPTEMBER 14, 2023

But as we talked to patients and providers, there was, really, this need for patients who wanted services, like IV antibiotics and IV fluids, but wanted to be able to spend that time at home, with their family, even if it meant it was their last days or weeks. You can broaden the scope of diagnoses. There are some subtleties there.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115