GeriPal

MAY 11, 2023

Then I went to medical school and I thought, “Well, should I go into psych? I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. We had diabetes, hypertension, risky medications.

Physicals 85

Physicals IT Hypertension Education 85

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). Were those people self referring, or family members calling you asking? Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

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?” We’re excited to welcome a full slate of guests today.

Families 97

Families Family Patient-Centered IT 97

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. Welcome to the GeriPal Podcast, Barbara.

IT 102

IT Family Families Clinic 102

GeriPal

OCTOBER 17, 2024

Summary Transcript CME Summary When treating heart failure, how do we distinguish between the expanding list of medications recommended for “Guideline Directed Medical Therapy” (GDMT) and what might be considered runaway polypharmacy? He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 27, 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 129

Illness IT Diagnosis Patient-Centered 129

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. This topic came up with Bernie published an article in New England Journal called Deciding for Patients Who Have Lost Decision-Making Capacity Finding Common Ground in Medical Ethics.

Family 112

Family Families Patient-Centered IT 112

GeriPal

JUNE 16, 2022

Alex: Today we are delighted to welcome Chrissy Kistler, who is a geriatrician researcher in the Department of Family Medicine and Vision of Geriatrics at the University of North Carolina, Chapel Hill. And so I trained as an epidemiologist before medical school, and started out studying prostate cancer. Alex: This is Alex Smith.

Management 122

Management IT Medical Patient-Centered 122

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. This is like, back in 2013, and I joined the faculty at the Icahn School of Medicine at Mount Sinai.

Individual 85

Individual Community IT Chronic Condition 85

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

JANUARY 18, 2024

Lastly, we discuss Katie’s paper on substance use disorder in an aging population and how one can incorporate the 5 Ms (ie, matters most, medications, mind, mobility, and multicomplexity) into a framework for age-friendly care for older adults with substance use disorder. Jessie: Yes. And then, looking at- Eric: Wow. So, one out of 10?

Illness 136

Illness Patient-Centered Screening IT 136

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. We’ll talk about is it in medical practice yet? It came after engaging her.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

MAY 9, 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.

Education 127

Education IT Illness Healthcare 127

GeriPal

FEBRUARY 6, 2025

We have two new FDA-approved medications that reduce that amyloid buildup and modestly slow down the progression of the disease. So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? But these tests were never designed to diagnose. Great to be back.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

AUGUST 31, 2023

We have a wide ranging conversation that touches on how to place aging, disability, and multimorbidity in the context of serious illness conversations, “striving toward normal,” stoicism, existentialism, psychedelics, the goals of medicine, medical aid in dying and more. We could have talked for hours! Bill: Thank you. Juliet: Lund, yeah.

Illness 128

Illness IT Diagnose Medical 128

GeriPal

AUGUST 17, 2023

Alex: And we’re delighted to welcome Nate Chin, who is associate professor at the University of Wisconsin, where he is medical director of their Alzheimer’s Disease research center and runs a large study in Wisconsin called the RAP Study studying Alzheimer’s Disease. And we’ve been diagnosing it at Penn.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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’m unsure what they do, how often they’re used, and who pays for their work. Jane: Right.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JUNE 9, 2022

We can’t possibly meet the needs of all people with newly diagnosed serious illness. I was always critical care bound since medical school. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. I’m controlling everything your placebo versus medication trials.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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. Nurse case management, social worker case management, medications, medical equipment, a home health aid, all that stuff goes away.

Family 106

Family Families IT Patients 106

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

APRIL 14, 2022

But that just didn’t really resonate with what I saw clinically which was that there was lots of suffering both in the patient, their family and on the clinical team and just felt it was really this space where I didn’t have a lot of evidence to guide me. Don’t worry about their alcohol use or drug use. Give some pleasure.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

FEBRUARY 16, 2023

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. What feelings do we have toward the patient and toward their families? And countertransference is everywhere.

Patients 109

Patients IT Family Families 109

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. And so I went into medical school wanting to cure cancer. Eric: Yeah. Alex: That’s right.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

MARCH 24, 2023

2021 Association of Hospice Profit Status With Family Caregivers’ Reported Care Experiences. We also have Joe Shega, who is a hospice physician, and he is a Chief Medical Officer and Vice President at VITAS Healthcare. Reading Ira’s article, it essentially was the VITAS Medical Director job description. Eric: Great.

IT 113

IT Provider Patients Family 113

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

JANUARY 11, 2024

Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). What’s up with Medical aid in dying in Canada? Eric: So again, the topic is going to be medical aid in dying in Canada. Four percent. Transcript Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

Illness 144

Illness IT Medical Provider 144

GeriPal

JANUARY 26, 2023

Alex: And we are delighted to welcome Sharon Brangman, who is a geriatrician and chair of the Department of Geriatrics at Upstate Medical University. And again, that can create a food desert, which can create health issues for patients and their families, so that’s an example of structural racism, but again, it’s baked into laws.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

FEBRUARY 22, 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.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

JUNE 13, 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 133

Illness Patient-Centered Patients IT 133

GeriPal

FEBRUARY 9, 2023

So most of our medical schools have simulation centers. I think the first time I noticed it was, like as a medical student when you would rotate on one service with one attending and they would make decisions about how to treat a case one way. We use simulation all the time in training our physicians.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

AUGUST 24, 2023

Summary Transcript Summary I hear the word dignity used a lot in the medical setting, but I’m never sure what people mean when they use it. Medical Assistance in Dying and Palliative Care: Shared Trajectories Transcript Eric: Welcome to the GeriPal Podcast. And we published in the Journal of the American Medical Association.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

OCTOBER 3, 2024

I was on a retreat with Guy Micco , who’s been on this podcast several times, and he was teaching a class on death while I was in medical school. What is it about the images of the dying that helps teach medical students? And dying is too big, too profound for any one model, including the medical model. That was it.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

FEBRUARY 2, 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.

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. But if they’re not going to live another 20 years, then there’s no point in giving them the extra medication for lowering their A1C.

IT 95

IT Clinic Screening Patients 95

GeriPal

APRIL 18, 2024

Then, it was like, well, it does as well as, and now, better than humans passing the medical boards, passing the law boards, doing great on the SAT, all that stuff. You and I would listen to a suggested list of diagnoses and say, “That’s a reasonable idea. They had no idea. Okay, that’s scary, but pretty impressive.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

JUNE 26, 2025

Disruptive events are medical, surgical. And hospitalization for pneumonia is like a medical event. We focus on function and mortality because these are outcomes that really are important to patients and families. May not even know that the patient has dementia, or they might think that, but it’s not been diagnosed.

Illness 93

Illness Hospital IT Patient-Centered 93

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. Here’s what I really want to know. I don’t know if any of you.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119