GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Because I might be able to cope and manage in one situation with the skills and supports that I have, and with those same skills and supports, and another situation kind of come unraveled. Brianna 00:41 Thanks.

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). Were those people self referring, or family members calling you asking? Eric: Yeah.

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. So the first thing, explain the diagnosis. And you’re in the ICU family meeting, and it gets heated.

IT 132

IT Illness Family Families 132

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

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. And we got all into his family stuff and how he’d been suffering with cancer and his goal.

IT 96

IT Patient-Centered Patients Board-Certified 96

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. Alex 10:22 So just to say that again, from the time of diagnosis. Like at the time of diagnosis.

Patient-Centered 71

Patient-Centered Illness Clinic IT 71

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. Like, with a cancer diagnosis, there’s relatively a smooth, smooth prognosis. I think for families and for other providers who are not trained in that, it’s very hard to predict.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Have you had a family history of substance use disorder? Jessie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

APRIL 14, 2022

Management of chronic pain in the elderly: focus on transdermal buprenorphine. And how am I going to manage their pain? And then part of our role as folks in palliative care who as Katie mentioned, really try to help folks manage distress around serious illness. Two great videos on buprenorphine initiation. Transcript.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

FEBRUARY 22, 2024

We might say, “Of course you’re sad, you just got a very serious diagnosis.” They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. Is this a new onset depression? Is this an adjustment disorder? I’m dying.” Just calling that out.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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

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. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. The family dynamics are different though. It was incredible. Abby: Yeah. Andrea: I agree entirely, Eric.

IT 83

IT Family Families Illness 83

GeriPal

OCTOBER 24, 2024

If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? I mean, I think, you know, people talk about withdrawal syndrome and it is an official DSM for diagnosis, but I’m not sure it’s. Is that your feeling, too?

Medical 98

Medical IT Patient-Centered Healthcare 98

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? And when they talk to patients and families, it’s a pretty easy sell.

IT 128

IT Family Families Patient-Centered 128

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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right.

Illness 110

Illness Hospital Patient-Centered Patients 110

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

JUNE 15, 2023

Now actually suggesting perhaps that you missed a diagnosis that you should have considered? Eric: A lot of talk about the Aducanumab of the world, these amyloid antibodies diagnosing people with dementia really early on potentially for treatment, but also a diagnosis of dementia may limit people’s ability to do things like driving.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 22, 2023

In many cases, the families were the victims of the crime. And we’ve really tried to serve that hospice mission of serving the patient and the family. And so not all of our patients still have friends or family in the community because they’ve been incarcerated for so long. They suffered from it.

Family 132

Family Families IT Community 132

GeriPal

OCTOBER 17, 2024

Eric 12:05 Any pearls on the diagnosis of HFpEF. So I would agree, just in terms of not trying to dismiss a lot of these patients in terms of deconditioning and really trying to sometimes hone in on the diagnosis despite a Bnp level that is not necessarily very high. A pill organizer, having family. What is GDMT?

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? 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? Fifty percent have a diagnosis in their record of decedents have dementia. She has advance dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

AUGUST 17, 2023

We invited three geriatricians and memory care doctors, Nate Chin, Sharon Brangman, and Jason Karlawish, to talk about this question and many others swirling around on how to safely prescribe these drugs and manage patients on them (like what to do about anticoagulation). And that could extend beyond 18 months. We just don’t know that.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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. John: I am what I am, which is a family practice doctor. ” I think the family would like you to consider how to work with that. That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 16, 2023

Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond.

Patients 109

Patients IT Families Family 109

GeriPal

FEBRUARY 29, 2024

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. Alex: And, it means pain management. Alex: We are only on the fourth of 10. They ordered mild to hot. laughter] Alex: Yeah. I’m sure we all have the same issue. Alex: Thank you.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. It’s easier to concentrate on cure, diagnosis, cure. People who are suffering are not very visible.

Community 115

Community IT Relationship Healthcare 115

GeriPal

AUGUST 31, 2023

He spent a long time as hospice medical director and he founded a national model of care that many of our listeners will be familiar with, AIM, which stands for the Advanced Illness Management program, which has influenced CMS policy. So she had them early in diagnosis and then a little bit later. Brad: Yeah.

Illness 128

Illness IT Diagnose Medical 128

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. Eric 05:46 So I got a question. So it’s a lot of palliation.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JANUARY 11, 2024

You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). 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.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 20, 2025

Alex 00:48 And we’re delighted to welcome back Josh Briscoe, who’s a palliative care doc at the Durham VA Medical center in Duke and blogs at Notes from a Family Meeting. And it was very clear, and she could now no longer recognize her family members. And the family says, dad would never want to live like this.

IT 87

IT Patient-Centered Patients Medical 87

GeriPal

JULY 6, 2023

Administration on Aging connecting you to services for older adults and their families California’s Master Plan for Aging New York’s Master Plan for Aging Transcript Eric: Welcome to the GeriPal Podcast. To learn more about what we talked about, check out the following links: Eldercare Locator, a public service of the U.S. Eric: And Susan?

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

And so we know that the decision to enter a nursing home is incredibly challenging for families, especially because it often comes with thoughts that they’re, like, abandoning their loved one, really. So it’s not just like the patient or the family, but it’s also the healthcare system.

Family 106

Family Families Patient-Centered IT 106

GeriPal

SEPTEMBER 19, 2024

Within eight weeks of diagnosis of advanced disease. Eric 23:45 Yeah, I love that, too, because I think that one for me really is, can our interventions need to target the patient population that we’re managing? It’s not just about physical symptom management. So I think that was one of the key eligibility criteria.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

MAY 1, 2025

Alex 00:07 We are delighted to welcome Peter Selwyn, who is a family medicine and palliative medicine doctor and chairman of the Department of Family and Social Medicine and director of the Palliative Care Program at Montefiore E instein and author of Surviving the the Personal Journey of an AIDS Doctor. Is a new diagnosis of HIV.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. It’s hard for your family to know. That this is iterative from diagnosis to end-of-life, right? But we’re going to have this forum for us to hear from family members, hear from patients, for them to hear from us.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

APRIL 20, 2023

We would drill down on the tenth differential diagnosis of medium vessel vasculitis, and then we would discharge them back out to the streets. Why was I spending all this time figuring out the detailed differential diagnosis of these obscure diseases when we weren’t actually attending to what people really needed?

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. 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.

Primary Care 79

Primary Care IT Clinic Illness 79