GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Alex: Yeah.

IT 102

IT Families Family Diagnosis 102

Doctor On Demand

APRIL 28, 2025

Urgent care clinics provide quick diagnoses and treatments, including antibiotics if needed. In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

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. Jessie: Yes. Jessie: Exactly. Eric: Which brings us to an article.

Illness 136

Illness Patient-Centered Screening Clinic 136

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

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 the answer is no, that probably was more just about do you need anybody to support you kind of emotionally or during this hospital stay, just give information to.

Family 97

Family Families Patient-Centered IT 97

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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

AUGUST 31, 2023

Alex: She’s also associate professor at Massachusetts General Hospital in Harvard Medical School. I just love her conclusion because what she realizes is when you’re first diagnosed… This is research. 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

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. The hospital refused without a court order, and the case eventually made its way to the Supreme Court. Laurie: Yeah, she was an On Lok patient, and I went in to see her in the hospital.

Families 112

Families Family Patient-Centered IT 112

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 Families Family IT 128

GeriPal

JANUARY 30, 2025

Essentially we’re testing the early integrated palliative care model, which is monthly visits with a specialty trained palliative care physician or advanced practice provider for patients who are diagnosed with advanced non small cell lung cancer. Lynn 37:39 I was in the hospital. But it really does need some individualizing.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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. We don’t want people dying in the hospital if their goal is to be at home.

IT 113

IT Provider Patients Families 113

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. And so I was really thinking about why are some of my people that are hospitalized doing better than others? 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

MAY 9, 2024

Alex: Generally in the hospital-based hospice. Matt: I’m more of a hospital guy. So I think that people like us feel more comfortable just talking to the public because that’s what we do every day of our careers, but not in the confines of a clinic or a hospital room. And that’s not particularly sexy.

Education 127

Education IT Illness Healthcare 127

GeriPal

FEBRUARY 27, 2025

I see this in the hospital when I’m doing addiction medicine consults. We got admitted to the hospital, our inpatient palliative team developed their skill set because they had a place to send patients when they got discharged. For those individuals, how do you think about that? I think it is just about any clinician.

Patients 72

Patients Clinic Patient-Centered Illness 72

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. We lump everybody who’s 65 and older together, and then we don’t look at the individual characteristics of that person, so we fall into these patterns based on racial premises.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

AUGUST 25, 2022

And then secondly, around some of our quality measures, there’s been differences found in multiple papers by many teams around hospice disenrollment, higher rates of hospice disenrollment in for-profit hospices, and higher rates of healthcare utilization. Because people, they go to the hospital, then they revoke. Lauren: Oh.

Families 106

Families Family IT Patients 106

GeriPal

FEBRUARY 9, 2023

It also feels like, I also grew up in med school in a three hospital system. There’s the variation between the hospitals, feels like there’s cultural issues that play a role. So then you drill down further, just like you said, Eric, when you were going back between different hospitals. Eric: Yeah.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

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 then my mom was diagnosed with lung cancer and she was treated there. It’s good. So proud of myself.

IT 102

IT Families Family Clinic 102

GeriPal

JANUARY 11, 2024

So I didn’t mention this at the beginning, but after my time as President of Canadian Psychiatric Association, I actually also went on to be the physician chair of my former hospital’s MAID team. Because in medicine as somebody who works in the hospital, there’s always other treatment options.

Illness 144

Illness IT Medical Provider 144

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. I got one more lightning question, Janet, you’re at UCSF you’re caring for a patient in the hospital.

Illness 102

Illness Patient-Centered IT Patients 102

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. They have so much going on.

Screening 99

Screening PCP PCP IT 99

GeriPal

AUGUST 24, 2023

Just an extraordinary cast of individuals who were really so incredibly inspiring. And then the final category, the third category is what we called the dignity conserving repertoire, which really has to do with kind of the spiritual, and psychological landscape and makeup of that individual. So tiny, tiny, in a hospital bed.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

SEPTEMBER 22, 2022

Stop thinking the physical exam or the differential diagnose, whatever, and just be there. I like to tell my trainees… Often with the earliest stage trainees, they’ll go in the room and they’ll ask the patient what brought them to the hospital. In the individual clinical encounter, that’s a lot of what we do.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

OCTOBER 27, 2022

James: Yeah, so I guess just to start… I mean, prognosis in general is kind of a term for predicted course of disease, and I think people commonly use it to refer to an individual’s life expectancy or how long the person has to live. I think this is a really difficult topic to talk about with patients.

IT 95

IT Clinic Screening Patients 95

GeriPal

AUGUST 8, 2024

So writing a eulogy or seeing that individual, we had an open casket, which was both very hard, but also, I would say, somewhat cathartic to actually do these rituals and participate in these rituals. It just depends on the family preference on the individuals involved. But there was something about the rituals that accompanied death.

IT 124

IT Families Family Relationship 124

GeriPal

OCTOBER 3, 2024

They had triple diagnoses, often life threatening illness, but also mental illness and usually some kind of addiction. And, like, you try to find a caregiver’s name in a hospital chart, you just can’t. Eric 36:36 I dare anybody to try to look up somebody’s caregiver’s name in a hospital chart. Yeah, yeah.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. And then when you see clinically patients coming into hospital, they’ll have, you know, they’ll be admitted for aspiration pneumonia.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

SEPTEMBER 19, 2024

Alex 00:34 We are delighted to welcome back Jennifer Tem e l, who is a thoracic oncologist at Massachusetts General Hospital in Boston. So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 26:47 How soon after from a hospitalization, all.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JULY 6, 2023

The idea was to create a robust community-based infrastructure that could help older adults succeed in their homes and communities, whether they were healthy, how to keep them healthy or they were at imminent risk of emergency room visits, hospitalizations, or nursing home placements. To Susan’s point. They touch every single system.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? Alex 00:18 Prognosis, super special today. And we have some great guests.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

MAY 1, 2025

One in 10 people with newly diagnosed HIV is an older adult. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. And I also read that 1 out of 10 newly diagnosed HIV cases are in older adults. People are living with HIV into advanced ages.

Primary Care 94

Primary Care IT Provider Clinic 94

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. And is it at all individualized to the patient? Before the primary care visit.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

DECEMBER 21, 2023

The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. Eric: And looking back at that time, what do you think the healthcare system could have done to help with that? With your journey, with your dad’s journey- Diane: They could have diagnosed him earlier.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

SEPTEMBER 14, 2023

Summary Transcript Summary Hospitals are hazardous places for older adults. These hazards include delirium, malnutrition, falls, infections, and hospital associated disability (which about ⅓ of older adults get during a hospital stay). 2020 Hospital at Home-Plus: A Platform of Facility-Based Care. Annals of Int Med.

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 Diagnose IT Physicals 141