GeriPal

FEBRUARY 16, 2023

Summary Transcript Summary Think about the last time a patient yelled at you in anger. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Ask why: What is underneath the anger for this particular patient? Taking care of the hateful patient.

Patients 109

Patients IT Families Family 109

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. What do different patient populations need? But watch out! Alex 01:06 Yeah, go in person.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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. When I see a patient? Matthew, I get the lyrics.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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? Something I’ll often point out to patients is, you know, how do you identify your emotions? On today’s podcast, we’ve invited Alex Gamble and Brianna Williamson to talk to us about anxiety.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

JULY 21, 2022

Initially, it was just because there weren’t really answers for my patients. 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. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

IT 102

IT Family Families Diagnosis 102

GeriPal

APRIL 3, 2025

That was actually Ken, you remember that article, Nancy Schoenberg’s article on screening and what to say and what not to say to patients on how to talk. How to talk to patients about screening colonoscopies. So therefore I feel that I am obligated to tell patients about this option. Ken 09:56 We did a role play.

IT 64

IT Hospital Screening Patients 64

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? And when I asked the patient, well, what happened, the test was sprung on them.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” Lynn: I do. Alex, can you play Send the Sun, by Nikki Lane?

Family 97

Family Families Patient-Centered IT 97

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. Then, “Keep your hand up if you frequently refer patients with cancer pain to a psychologist?” That rings true to me. All hands go up. All hands go down.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Patient-Centered 52

Patient-Centered Complication IT Patients 52

GeriPal

AUGUST 17, 2023

However, as noted in our editorial published with the donanemab trial , the modest benefits of amyloid antibodies would likely not be questioned by patients, clinicians, or payers if amyloid antibodies were low risk, inexpensive, and simple to administer. The patients continued to be followed. However, they are none of these.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

AUGUST 31, 2023

This sort of stands in the face of what you and I learned in palliative care that illness is an opportunity for spiritual growth and transformation from what we have strived towards in caring for many of our patients. One colleagues of mine in the Netherlands did just interviews with 30 cancer patients and this theme kept coming out.

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. 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

SEPTEMBER 1, 2022

So I’m going to last longer in my position and I’m going to seek opportunities to grow and to help families and patients more and more. We’re just like, “Okay, I see this patient has a need. For example, there was one time when a patient had hiccups, it was like, “I don’t know what to do about this.”

IT 102

IT Families Family Clinic 102

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

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. In one room the physician under study interacts with a white patient-actor, and in another room interacts with a Black patient-actor.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

JANUARY 26, 2023

Ramona: Well, I’ve always been interested in health equity, always been interested in looking at disparities, and the disparities that I have looked at most often have been for patients at the end of their lives. The trainee said to me something like, “But I haven’t seen any geriatric patients yet.” Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

SEPTEMBER 22, 2022

Have you ever had that moment when talking to a patient, when you realized that the phrase you just uttered, which you’ve uttered a hundred times before, came out rote and scripted? And in response, the family or patient looked at you like you were from another planet? Well, it’s not just being present, though. Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

JUNE 19, 2025

You present your. And also kind of highlights, you know, part of what we try to do in geriatrics and palliative care is really individualize how we care for individual, like, the people in front of us, the patients, the caregivers, their family members, their friends. So that’s how. Just how you. Your gender. We need to.

Individual 81

Individual Community IT Chronic Condition 81

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

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. Jane, welcome to the GeriPal podcast. Jane: Thank you for having me. John: Yeah.

Provider 117

Provider Illness IT Healthcare 117

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. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. And you were a guest at that retreat, and you brought photographs of patients from the Zen center and had us view them, think about them, talk about them, and perhaps even write about them.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. And importantly the patient has to have capacity and they have to be able to take the drug themselves. So being well and also potentially periods of dying. Eric: Bill.

Illness 144

Illness IT Medical Provider 144

GeriPal

SEPTEMBER 21, 2023

I’m concerned about how can I get my dad diagnosed or get this proper care.” Even in my own culture, we see that as being extremely important, and we should as healthcare providers never negate that. But I think that nursing, we look at things holistically, and so we just don’t focus just on that patient.

Community 128

Community Family Families IT 128

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. It is appropriate for all patient populations, and it is developed specifically for the palliative care and hospice populations. Why do this?

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). I’m hearing dementia patients or patients with dementia. Eric 09:15 And then who were the patients just with dementia or were they. Is that right?

Primary Care 79

Primary Care IT Clinic Patient-Centered 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. People are living with HIV into advanced ages. Meredith 11:29 Yeah. And that was.

Primary Care 94

Primary Care IT Clinic Provider 94

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. And just going back to that patient, I’ll tell you, before I started this role, I would have probably looked at the handout box in our clinic and been like, oh, okay. Is it the patient?

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JUNE 6, 2024

Summary Transcript Summary As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. But one issue we’re not as good at discussing with our patients is sexual health. Clearly this issue is important to patients. You know, I address all the supportive care needs of my patients.

Illness 130

Illness IT Physicals Patients 130

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. You can’t just give that value to a patient. Eric: Wonderful. laughter] Heather: Good point.

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.” Care Ecosystem.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

AUGUST 22, 2024

Right, my answer that brings us a little bit closer to the present than my childhood. Patients families want to know whether their loved one has died. Doctors want to know whether the patient has died. You know, when is it okay to harvest organs from a patient? So there may be caps if the patient died versus no caps.

IT 113

IT Families Family Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. 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.

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 IT Diagnose Physicals 141