GeriPal

JUNE 27, 2024

Summary Transcript Summary “Anxiety is a lot like a toddler. It never stops talking, tells you you’re wrong about everything, and wakes you up at 3 a.m.” I’m not sure who wrote this quote, but it feels right to me. Brianna is one of UCSF’s palliative care fellows who just completed her psychiatry residency. Alex Gamble, do you have a song?

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). There is a dearth of Certified Driving Rehab Specialists: 12 for the entire state of Colorado!

IT 102

IT Family Families Diagnosis 102

GeriPal

AUGUST 29, 2024

It feels nearly impossible if you add another degree of difficulty, whether it be a crying interpreter or a grandchild from another state who shows up at the end of a family meeting yelling how you are killing grandma. That’s a hard enough task, given that most of us have never had any communication skills training. Gordon 02:02 I do.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. Should you stop at “no?” We will have to reach out to your daughter then to help with decisions.

Families 97

Families Family Patient-Centered IT 97

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. This is not highly scripted orchestral music, people, its Jazz. -S Tyler 01:12 AHPM.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

SEPTEMBER 28, 2023

First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Summary Transcript Summary Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. Simple, right? Eric: Yeah?

Family 144

Family Families Patient-Centered IT 144

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. But are we really taking full advantage of ALL social workers have to offer our field? by: Anne Kelly, LCSW, APHSW-C.

IT 102

IT Family Families Clinic 102

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. Summary Transcript CME Summary It is a battle royale on this weeks GeriPal podcast. But watch out!

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. Jace, welcome to the GeriPal Podcast. Noelle Marie 01:19 Cyndi Lauper’s True Colors.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. It can mean many things, including a specific type of plant, the chemicals in the plant, synthetic analogs, or products that have these components. Eric 00:49 And I just want a big shout out to Alex Gamble, who said, we have to get Eloise on a podcast to talk about this topic. Do you want one?

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

JUNE 15, 2023

Hallucinations, or when the AI lies or b *s, then denies it When the AI approaches sentience, is it ethical to unplug it? I’m sure this is a subject we will return to, given the rapid progress on AI. But then it asked me, “Oh, that sounds really interesting. Who are you going to be talking to?” ” And I said, “Sure.”

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JULY 11, 2024

Summary Transcript Summary In May we did a podcast on KidneyPal (the integration of palliative care in renal disease) , which made us think, hmmm… one organ right next door is the liver. Maybe we should do a podcast on LiverPal? (or or should we call it HepatoPal?) ABIM MOC credit will be offered to subscribers in November, 2024. Excited to be here.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JUNE 9, 2022

By diagnosis? We talk with Kate about how despite how far we’ve come in palliative care research, we still don’t have answers to some fundamental questions, such as: Who should get specialized palliative care? Should eligibility and access be determined by clinician referral? By prognosis? Can nudges help? What is a pragmatic trial ?

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

OCTOBER 12, 2023

Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Family Families Patient-Centered 128

GeriPal

MAY 4, 2023

Eric: So we’re going to be talking about palliative care for adolescents, and young adults. Why does it feel different? Does it feel different? How should we think about the care? But before we do, Abby, I think you have a song request for Alex. Abby: I do. So I requested that Alex play for us, Let It Grow, which is from The Lorax soundtrack.

IT 83

IT Family Families Illness 83

GeriPal

JUNE 16, 2022

We discuss with her how we should work-up and manage “urinary tract infections” (I’ve added air quotes to “UTI” in honor of Tom Finucane’s JAGS article titled “Urinary Tract Infection”—Requiem for a Heavyweight in which he advocated to put air quotes around the term UTI due to the ambiguity of the diagnosis.). Alex: This is Alex Smith.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

APRIL 14, 2022

But that just didn’t really resonate with what I saw clinically which was that there was lots of suffering both in the patient, their family and on the clinical team and just felt it was really this space where I didn’t have a lot of evidence to guide me. It’s been around for a long time but is acting like the hot new kid in town.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

FEBRUARY 29, 2024

The hot sauces progressed from mild to extreme (and I mean extreme) heat. Can I just say…it works? Being asked a question with your mouth on fire, sweat streaming down your face, feeling the most awake and terrified you have ever been in your life, forces you to give an unadorned answer, straight from the heart. Lynn: Okay. Anne: GeriPal edition.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

OCTOBER 17, 2024

We’ve also invited two amazing cardiologists, Parag Goyal and Nicole Superville, to join us about GDMT in heart failure with reduced ejection fraction (HFrEF) and in Heart Failure with preserved EF (HFpEF). He’s in Boston. He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge. Parag 01:06 Thank you.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 18, 2024

Summary Transcript Summary The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise. Jessie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

MAY 9, 2024

Alex: And Sammy Winemaker, who’s a palliative care physician and Associate Clinical Professor at McMaster University in the Department of Family Medicine, Division of Palliative Care. He was also the one who we have to thank for suggesting this podcast! ABIM MOC credit will be offered to subscribers in November, 2024. Great title.

Education 127

Education IT Illness Healthcare 127

GeriPal

JUNE 22, 2023

We start off part one by interviewing Michele DiTomas, who has been the longstanding Medical Director of the Hospice unit and currently is also the Chief Medical Executive for the Palliative care Initiative with the California Correctional Healthcare Services. Afterwards, we chat with the prison’s chaplain, Keith Knauf. Eric: Yeah.

Family 132

Family Families IT Community 132

GeriPal

FEBRUARY 22, 2024

Unfortunately, we lack the financial structures to reimburse psychologists that would incentivize widespread inclusion on palliative care teams. Because we live in the world as it is, not as it should be, Des has helped develop an app ( link to pilot trial hot off the press !) ABIM MOC credit will be offered to subscribers in November, 2024.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

AUGUST 17, 2023

There is a lot to digest with these draft clinical guidelines but the big change from the 2018 guideline is moving Alzheimers to a biological diagnosis (biomarker evidence only) not just for a research framework but now from a clinical one. Eric: Yeah, he is the host of my favorite dementia podcast. Dementia Matters. Dementia Matters.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. 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.

Family 106

Family Families IT Patients 106

GeriPal

FEBRUARY 16, 2023

As Keri put it in the podcast, we must go beyond “a hammer and a nail” philosophy to approaching anger by developing a toolkit for anger that is vast and varied. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Is that you Dani? Dani: It is me. laughter] Alex: Not at all.

Patients 109

Patients IT Family Families 109

GeriPal

JUNE 30, 2022

And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. Before we go into this topic, who has a song request for Alex? Here we go.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. 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. But before we do, I think somebody has a song request for Alex. Alex: Can’t tell…maybe a little bit.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. The answers to these questions will vary. Reasonable people will disagree. Welcome, Karl.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

BMJ

MAY 10, 2022

Family physicians and family health workers, considered reliable sources of vaccine information, have a unique position where individuals in rural and urban areas can access frequently, uninterruptedly, cheaply, and easily [2]. Two hundred seventy-six of the healthcare professionals were reached (response rate: 85.4%).

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. I’m unsure what they do, how often they’re used, and who pays for their work. But before we jump into that topic, John, do you have the song request for Alex?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MAY 12, 2022

Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. Prognosis communication and the subtle ways we may communicate it without intention. Social pain and loneliness. Community-based palliative care networks . Raj’s reflections on the state of palliative care in the US. Transcript.

Community 115

Community IT Relationship Healthcare 115

GeriPal

JANUARY 11, 2024

What happened is that firstly, in terms of my clinical background, my background is psycho-oncology, so that’s working with patients with cancer and their families, including when they’re going through periods. Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). Four percent.

Illness 144

Illness IT Medical Provider 144

GeriPal

AUGUST 31, 2023

I am honored to introduce Bill Gardner, who’s a child psychologist and professor of psychiatry and epidemiology at the University of Ottawa. We have a Canadian theme going. We just had Harvey Chochinov on. Bill, welcome to the GeriPal podcast. Can you believe that this is happening?” Was it April 1st?” Juliet: It was great.

Illness 128

Illness IT Diagnose Medical 128

GeriPal

FEBRUARY 9, 2023

And when you and I talk about, what’s the key medical decision or diagnosis that we’re making all the time, we’re making a decision about like, “Is this patient sick enough to die? We’re going to define what that is and how it applies to the work that we do. Amber: I do. You know what? Alex: That’s great.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. What does it look like to take a palliative approach to severe mental illness?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

SEPTEMBER 8, 2022

Holly has accumulated mountains of evidence for the diagnosis of prolonged grief disorder as a specific condition primarily notable for a yearning over a year after the death. This led her on a remarkable journey. Prolonged grief is associated with increased risk of suicide and other negative health outcomes. Holly: Yes, I do. Alex: Right.

IT 100

IT Relationship Complication Specialization 100