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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GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Eric 01:42 So we’ ve got an exciting topic today.

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IT Illness Family Families 132

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

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Illness Mental Health IT Patient-Centered 101

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?” Anne Kelly: Hi there. Nice to be here. Eric: Lynn or Anne?

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Family Families Patient-Centered IT 97

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). Love to talk about also in the serious illness population. Eric: Yeah. Is this our role?

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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. A “Three-Stage Protocol” for Serious Illness Conversations: Reframing Communication in Real Time Transcript Eric: Welcome to the GeriPal podcast. Simple, right?

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GeriPal

JUNE 9, 2022

By diagnosis? 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. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them.

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GeriPal

MAY 4, 2023

There’s all this stuff that we’re supposed to be doing at that stage of life and then you add the complexity of the serious illness. It is really difficult for the patients and the families. Young adulthood is super hard. Daniel, does that play a role as far as… I have a 14-year-old son. Thoughts on that?

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GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Transcript. Eric: Yeah.

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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 so when you have that, that’s so good for the family. That’s so good for us.

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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!

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GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience. And it was like the lights came on.

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IT Patient-Centered Patients Board-Certified 96

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. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me. Eric: Yeah.

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GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. 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. Sammy: Thank you so much.

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GeriPal

JUNE 15, 2023

Now actually suggesting perhaps that you missed a diagnosis that you should have considered? Because the in serious illness care and care for older adults, their care is often very complex. And patients and family members tell us that they worry that their clinician is going to be overly focused on that mortality number now.

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IT Patient-Centered Patients Healthcare 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. But that was separate from MAID.

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Illness IT Medical Provider 144

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. And this really allowed, I think, other people to celebrate themselves and the families, family members who are going through the same type of journey. Happy pride and thanks for the invitation, Alex and E.

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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? But we know that 30% of all decedents who are Medicare beneficiaries either die from dementia or have an existing diagnosis of dementia, which is something we talk about quite often, Joel and I.

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Patient-Centered Complication Patients IT 101

GeriPal

FEBRUARY 29, 2024

Not the most common circumstances that people with serious illness face where attention and understanding of what my goals and values are. Eric: I do not want my family to listen to my podcasts. So, I generally don’t listen to the podcast afterwards, nor force them on my family. ” Very specific, rare circumstance.

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IT Patient-Centered Illness Education 126

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. He looked very ill. John: I am what I am, which is a family practice doctor. I’m unsure what they do, how often they’re used, and who pays for their work.

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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? What I need to navigate with that patient and their family, is it valuable to you? I did it before and this guy, he was 85, but he was climbing Mount Everest.”

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IT Family Families Patient-Centered 128

GeriPal

JUNE 22, 2023

But now we have older people dying of older people illnesses. Alex: And are the regulations similar or different in terms of six month required prognosis or less, should the disease take its usual course, or illnesses leading to a short prognosis? In many cases, the families were the victims of the crime. Eric: Mm-hmm.

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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.

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Family Families IT Patients 106

GeriPal

JULY 11, 2024

We get a bit of, in the veteran population, kind of a mix of a lot of mental health issues thrown into these comorbid illnesses, including cirrhosis, but it’s usually the decompensated cirrhotics or the folks with liver cancer and cirrhosis, or one of both. And it’s usually those people that I’m seeing.

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GeriPal

OCTOBER 19, 2023

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. And he’s a professional Uber driver for his daughter’s softball games.[laughter] Alex: National POLST Collaborative.

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Patient-Centered IT Patients Illness 126

GeriPal

OCTOBER 24, 2024

Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness. But you really should be looking at family history, personal history.

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Medical IT Patient-Centered Healthcare 98

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. What feelings do we have toward the patient and toward their families? And here’s an incredibly angry family member. How did you react? Afterwards, I thought there must be a better way.

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Patients IT Family Families 109

GeriPal

MAY 12, 2022

It’s easier to concentrate on cure, diagnosis, cure. When we think about palliative care delivered here, like individuals with chronic pain, non-serious illness chronic pain, non-life threatening illness, oftentimes if we get consulted on them, we don’t even see them, may just be discontinued in most palliative care places.

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GeriPal

JULY 3, 2025

And I was curious to learn about how people were talking about what to expect after a diagnosis of advanced cancer, how clinicians were counseling patients, how patients were understanding their prognosis and making decisions. What is serious illness like? What does serious illness mean? Like at the time of diagnosis.

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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. So we did a perfect cross so that the race and actual primary diagnosis was perfectly matched across groups. There’s that recognition piece.

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Patient-Centered Patients IT Healthcare 111

GeriPal

MARCH 20, 2025

We discussed what makes an illness terminal, what goes into assessing capacity for an action as simple as requesting something to drink, and whether the TV show Severance illuminates any of these answers. But before we talk about this subject, about nutrition, hydration at the end of life, people with advanced illness, or maybe not so much.

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IT Patient-Centered Patients Medical 87

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. Alex: Their own death in advance, terminally ill people. They don’t want to interact with their family. This led her on a remarkable journey.

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IT Relationship Complication Specialization 100

GeriPal

OCTOBER 27, 2022

And if you look at previous kind of population-based studies, the median survival time after diagnosis is really broad and can range based on the study from 3 to 12 years. So we wanted to create a model that’s going to reflect that sort of risk and what it also means for their families and financial decisions.

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GeriPal

FEBRUARY 24, 2022

Juliet and Rachelle are two of the authors of a recent JAMA viewpoint titled “Shifting to Serious Illness Communication.” . Also see the image below from Alex’s editorial in JAGS , a Venn diagram of advance care planning and serious illness communication. Shifting to Serious Illness Communication. Transcript. What is it?

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Illness Patient-Centered IT Family 98

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

JUNE 6, 2024

Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. So we got a lot to cover on sexuality, sexual health, and serious illness. So this is about two and a half, three years out from leukemia diagnosis. Don, welcome to GeriPal. Don 01:11 Thank you so much. Arish, I missed your talk.

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GeriPal

SEPTEMBER 19, 2024

Alex 12:36 And most of our listeners are like clinician, practicing clinicians caring for older adults, people with serious illness. Within eight weeks of diagnosis of advanced disease. So in chronically critically ill patients, the idea that one visit is going to do anything is just. Is this superior to that? Palliative care.

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