GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Katie, before we jump into the topic of buprenorphine in serious illness, what’s the song request?

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

AUGUST 31, 2023

Summary Transcript Summary How do people react when they hear they have a serious illness? And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness. Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).

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Illness IT Diagnose Medical 128

GeriPal

SEPTEMBER 22, 2022

Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. One bump is just the classic pitfalls we often talk about in serious illness communication: being very jargony, very information focused, and just providing information. It flows very well. Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

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. To note that I am an individual who goes through this world. I face a lot of different stressors and challenges similar to other individuals, but I also have my own unique experiences. Noelle Marie 01:15 I do.

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Individual Community IT Chronic Condition 85

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. Emmy: So that older person or person with maybe terminal illness or developing impairments, it might make sense for them to just keep driving because they don’t have a good replacement. Eric: Well, Terri and Emmy, thank you for joining on this podcast. Alex: Yeah.

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Families Family IT Diagnosis 102

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. Areej: So when I was in college, I had a close friend who had a serious illness and actually died as a result of cancer. I entered medical school and I did a course that was offered that’s called living with a life threatening illness.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. And bringing more palliative care to the living with serious illness instead of dying from serious illness population.

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Consulting Patient-Centered Diagnosis Referral 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. So less than six months to live.

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Illness IT Medical Provider 144

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. So we are going to leapfrog over the healthcare system education and we’re going to go straight to the citizens of the world and we’re going to give them the insider tips to how to improve their illness experience.”

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Education IT Illness Healthcare 127

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?

Families 97

Families Family Patient-Centered IT 97

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. The patient refuses to ever talk about the fact that this illness could take their life.

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Telehealth Patient-Centered IT Patients 105

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 I think that there is room for shortening the duration if your patient is non-immunocompromised and not severely ill. Eric: That’s pretty impressive.

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Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Eric 00:51 So we’re gonna be talking about caring for people with serious illness and substance abuse. Who has a song request for Alex before we talk about substance use disorder and serious illness?

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Patients Clinic Patient-Centered Illness 72

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?

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Primary Care Diagnosis Screening IT 95

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

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. It sets space between us and the individuals we’re trying to take care of. The last thing I’ll say is I actually saw his very last performance.

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Provider Illness IT Healthcare 117

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. In fact from the time he was diagnosed, he passed away within two and a half weeks.

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IT Community Patient-Centered Medical 99

GeriPal

AUGUST 24, 2023

Fox gives patients hope there may be a place that illness doesn’t touch Depression is a Liar Why is Being a Patient Such a Difficult Pill to Swallow Better Patient Care Calls for a ‘Platinum Rule’ to Replace the Golden One. Just an extraordinary cast of individuals who were really so incredibly inspiring. Eric: Sorry, I was on mute.

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Patient-Centered Patients IT Illness 98

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?

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IT Provider Patients Families 113

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. Eric: Yeah.

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IT Families Family Clinic 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. They were seriously ill and had a chance to get to know. And the goal about treating reversible illness that we tried to put in with that got taken out. What words to use?

Families 112

Families Family Patient-Centered IT 112

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. Melissa: The other scenario that exists is just disenrollment because an individual is hospitalized. But we were pleasantly surprised.

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Families Family IT Patients 106

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.

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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. I cracked myself in my head of these individuals.

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IT Patient-Centered Patients Relationship 122

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.

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IT Clinic Screening Patients 95

GeriPal

AUGUST 8, 2024

And I think, oh, there was something she did besides getting cancer and dying, which requires such a focus, you know, cancer and terminal illness of any kind. It just depends on the family preference on the individuals involved. I have a catch in the breath when I see a picture of her in rude good health.

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IT Families Family Relationship 124

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.

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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. 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.

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Patient-Centered IT Patients Hospital 119

GeriPal

MARCH 27, 2025

Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. So we sent that to everyone 65 and older with upcoming visits, though we were tracking on our side the people who had diagnoses and things. And is it at all individualized to the patient? It’s a lot.

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Primary Care IT Clinic Illness 79

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.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

DECEMBER 1, 2023

And the two were sort of intermeshed even to the point in the eighties, the thought was all dementia is Alzheimer’s or it’s some medical illness or combination of other stuff that’s not about it. That’s in my view as analogous as to any other illness. You need the plaques to have that illness.

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IT Clinic Illness Hypertension 115

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.

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Primary Care IT Provider Clinic 94

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.

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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).

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