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? How should we screen for cognitive impairment? Does a good history matter anymore?

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). That rings true to me.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? We then walk through how we should screen for anxiety and how we should think about a differential. Something I’ll often point out to patients is, you know, how do you identify your emotions?

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

JUNE 16, 2022

So I actually got started in cancer screening also, thanks to some mutual colleagues. Very interested in decision making around as we get older, individualizing care, sort of patient centered, values driven, it’s a tough decision to figure out. Like for me, my NF1, is it a good idea to get screened for cancer or not?

Management 122

Management IT Medical Patient-Centered 122

GeriPal

JULY 28, 2022

I had it on my screen. 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 it was a longitudinal course where we spent time with a patient with a serious illness the entire year, the entire first year of medical school.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 2, 2024

First, in our editorial, we expressed concern about the length of stay metric not being patient centric, though important for health systems focused on cost savings. And PAIR stands for the Palliative and Advanced Illness Research Center. Also a core faculty member at the PAIR Center at the University of Pennsylvania.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

APRIL 13, 2023

But, should we as clinicians care about the social lives of our patients? Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? And so I began to think about the training that I had and that there was no mental health condition that was diagnosed.

IT 99

IT Community Patient-Centered Medical 99

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. So I identified myself, and was working in our local cancer center.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Alex: We also have Mike Rabow, who is director of palliative care at the Cancer Center at UCSF. Isn’t that what we always work with, with patients, with our colleagues, with ourselves? Redwing: Thank you.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

DECEMBER 1, 2023

In particular we spend a good deal of time talking about what this means for asymptomatic patients who may have an abnormal biomarker, which by the proposed new definition would mean they would now have Alzheimer’s disease. Of course, the three of you are directors of centers that study this issue are deeply involved.

IT 115

IT Clinic Illness Hypertension 115

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.”

Patient-Centered 125

Patient-Centered IT Families Family 125