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

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

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 9, 2022

By diagnosis? But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. Eric: Our outpatient service does have guides around diagnosis and prognosis.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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. You’re recognizing that, wow, this could happen to me, and I wonder sometimes about the challenges.

IT 83

IT Family Families Illness 83

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. Gender expression is your physical outward manifestation of how you express your gender identity.

Individual 85

Individual Community IT Chronic Condition 85

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 11, 2024

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. And you’re working with a patient that almost is like a dementia patient, depending on how much lactulose they’ve been taking.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JUNE 15, 2023

Now actually suggesting perhaps that you missed a diagnosis that you should have considered? I actually like reading books and the physical,” and what the internet 2.0 And patients and family members tell us that they worry that their clinician is going to be overly focused on that mortality number now. Eric: Yeah.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 22, 2023

We really like the community doctors to know, so those of you listening, that our patients, they’ve lost their physical freedom, but they have autonomy in terms of their medical decision-making just like anybody else. In many cases, the families were the victims of the crime. They suffered from it. We’ve had baptisms.

Family 132

Family Families IT Community 132

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

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. Jennifer: Oh nice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 22, 2024

A lot of those symptoms of depression can also be attributed to different kinds of physical symptoms. 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.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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. How you actually physically started doing this and built up so many followers over time and why are you doing it? Hsien: Hey, great to be here.

Education 127

Education IT Illness Healthcare 127

GeriPal

FEBRUARY 16, 2023

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. What feelings do we have toward the patient and toward their families? I wish they were just a diagnosis.

Patients 109

Patients IT Family Families 109

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

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. The post GeriPal 300th Episode: Ask Me Anything Hot Ones Style appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional. Alex: Thank you.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 12, 2022

It’s easier to concentrate on cure, diagnosis, cure. What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. We know that this is necessary in theory, we know that health is not only absence of disease, but physical, social, and mental wellbeing. Healthcare industry cannot do it.

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. Alex: Self-administer and psychiatric illness is not considered a qualifying diagnosis. Eric: Yeah. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

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? They look at the signs and symptoms, they do a physical exam, maybe some lab tests or some imaging. And so have some of my mentees.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

DECEMBER 19, 2024

It’s one of the core things that we think about palliative care is you got the physical, psychological, social and spiritual symptoms. So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families? Eric 05:46 So I got a question. Very, very common.

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. And what we mean is like they’re physical numbness or they trip over that particular symptom, but it’s that sense of detachment from living people.

IT 100

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.

IT 95

IT Clinic Screening Patients 95

GeriPal

SEPTEMBER 19, 2024

Within eight weeks of diagnosis of advanced disease. We did not just rely on a physical symptom measure, which many of our colleagues are doing. It’s not just about physical symptom management. So I don’t know how clinically meaningful that week difference was to families. English or spanish speakers.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

Wait, so one key message is that social health is linked to physical and cognitive health?!? We focus on function and mortality because these are outcomes that really are important to patients and families. And the government can do something about that?!? Yes indeed, we like to hammer that home regularly, dear listeners.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JULY 25, 2024

So how physically active the patient is, how much time they spend awake, how much they’re eating, how much care they need, that type of thing. And just like cultural background, there are some individuals and families that would really never have their loved one enter a nursing home, choosing instead to take care of them.

Family 106

Family Families Patient-Centered IT 106

GeriPal

JUNE 6, 2024

So this is about two and a half, three years out from leukemia diagnosis. It sits at the intersection of emotion, interpersonal, physical, psychological, cultural. All guests agree that clinicians feel they need to have something they can do if they open Pandora’s box. And I said, sure. We haven’t really talked about this.

Illness 130

Illness IT Physicals Patients 130

GeriPal

FEBRUARY 24, 2022

And it was really good for my mental and physical… Physical health, obviously, but mental health really. 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?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. And I have a long interest in identifying family caregivers and supporting them in care delivery. And so this was really, in my view, a perfect window for reinforcing the role of family in primary care. Eric 02:32 Great, Alex.

Primary Care 79

Primary Care IT Clinic Illness 79

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

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.” Malaz: I love it.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

SEPTEMBER 14, 2023

But as we talked to patients and providers, there was, really, this need for patients who wanted services, like IV antibiotics and IV fluids, but wanted to be able to spend that time at home, with their family, even if it meant it was their last days or weeks. Bruce: This is, Ghostbusters, basically, a ham radio. Eric: Yeah.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 16, 2024

Ken Covinsky reminds us that we should not be making a diagnosis based on what we see on TV, and that if a patient’s daughter expressed a concern that their parent “wasn’t right,” we would conduct an in depth evaluation that might last an hour. Cecilia Poon says, what are some best practices to highlight professional ethics?

Diagnosis 141

Diagnosis Diagnose IT Physicals 141