GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. Yes, over diagnosed in older adults are about right.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JULY 21, 2022

That’s where it really gets to this individual risks and balances, individual situation. And I’ve been to some presentations that use that same breaking bad news model for having these driving conversations, as are used in palliative care. Alex: Yeah. Terri, I wonder if you could comment on that. Absolutely.

Families 102

Families IT Family Diagnosis 102

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 17, 2023

So what is the role of individuals like geriatricians in prescribing amyloid antibodies and caring for individuals who are receiving them? And I do think geriatricians need to as individuals make that decision, largely based on their comfort with the diagnostics and the specifics of the therapeutics. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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. But it really does need some individualizing. Abstract presenters as well.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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 96

Primary Care Diagnosis Screening IT 96

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

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. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. Devika: That’s right.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

AUGUST 31, 2023

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. He really helped me a lot through the shock and awe of being diagnosed with cancer. Brad: Yeah.

Illness 128

Illness IT Diagnose Medical 128

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. It sets space between us and the individuals we’re trying to take care of.

Provider 117

Provider Illness IT Healthcare 117

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. No, I mean, I think I had the initial feeling or thought about this being present after I learned about it and were thoughtful with senior mentors about it. You just knew it? Thomas: Yeah, yeah. I would say that.

IT 99

IT Community Patient-Centered Medical 99

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 92

IT Patient-Centered Healthcare Patients 92

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 98

Families Family Patient-Centered IT 98

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

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. I’m fully present.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

JANUARY 11, 2024

One thing I would like to add here is both Sonu and Leonie presented this as something that lacks boundaries. So it started off for individuals with a terminal illness. All of the evidence shows that for mental illnesses in individual cases of mental illness, we cannot make those predictions. Eric: Bill. Bill: Yeah.

Illness 144

Illness IT Medical Provider 144

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. People would present with horrible opportunistic infections, not just pneumocystis pneumonia, but CNS infections with toxoplasmosis and wasting syndrome, of course.

Families 112

Families Family Patient-Centered IT 112

GeriPal

OCTOBER 3, 2024

And finally, Wendy offers a drawing lesson and ONE-MINUTE drawing assignment to help us (and our listeners) be more present and connect with one another. First you have to be a volunteer and see what it’s like to be present at the bedside. The rules are really quite simple: Find another person. Frank 08:43 Well, briefly.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

FEBRUARY 9, 2023

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. And so the control room is a contiguous room, but the individual rooms where the patients, the actors and the doctors are separated by a wall. They’re side to side.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

SEPTEMBER 22, 2022

Well, it’s not just being present, though. Stop thinking the physical exam or the differential diagnose, whatever, and just be there. In the individual clinical encounter, that’s a lot of what we do. But also culturally how can modern healthcare systems build back trust when people so often distrust systems?

Illness 101

Illness IT Patient-Centered Patients 101

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

JULY 6, 2023

I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. Again, as Greg said, where the individual chooses what works best for them. To Susan’s point. Older people don’t live in the Offices for the Aging. They touch every single system.

Community 89

Community Nurse Practitioner Provider IT 89

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. That just leads to issues that can make home care very difficult for these individuals.

Families 106

Families Family Patient-Centered Patients 106

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

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 Clinic Provider 94

GeriPal

DECEMBER 1, 2023

I think that the actuarial data are compelling, that elevated amyloid alone in some individuals can lead to downstream dementia. I haven’t yet seen those clinical trials with beta-amyloid in asymptomatic individuals to allow me to reach that conclusion. That’s what got hyperlipidemia turned into hyperlipidemia.

IT 116

IT Clinic Illness Hypertension 116

GeriPal

DECEMBER 21, 2023

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. They could have diagnosed him earlier. So that’s I think diagnoses. And we find out, oh, there is no demand.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

SEPTEMBER 14, 2023

JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis. You can broaden the scope of diagnoses. In our larger studies, before the study that Tacara helped lead, we never required family members to be present, or do work.

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