GeriPal

FEBRUARY 22, 2024

We might say, “Of course you’re sad, you just got a very serious diagnosis.” Because often what we hear from patients, “I do a lot of pain management research,” but mood comes up in that a lot, is that, “Oh, I don’t want to talk to my doctor about this. Is this a new onset depression?

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. However, there are “Red Flag” symptoms that require urgent evaluation and management.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Is this our role?

IT 102

IT Families Family Diagnosis 102

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. So our inpatient hospitals are kind of under resourced for music therapy. That’s.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. 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.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 17, 2024

And in fact, as Alex mentioned in the intro, probably more than 20 years ago, Muriel Gillig asked me to help out with the geriatric modules at the Brigham women’s hospital primary care medicine sort of sessions. Eric 12:05 Any pearls on the diagnosis of HFpEF. And I know one of the topics I did was polypharmacy then.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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

JANUARY 30, 2025

But in reality, given workforce shortages and just the challenges and the resources necessary to be able to provide early integrated palliative care from the time of diagnosis of advanced cancer, the model simply is not implementable, at least not in our current state with our available infrastructure and resources. And well skilled.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

FEBRUARY 27, 2025

Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness – should we/can we split up the once daily dosing to achieve better pain control? When to consider bupenorphine vs methadone? They’re often angry.

Patients 72

Patients Clinic Patient-Centered Illness 72

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. Maybe we’ll get to talking about that today. Jessie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. Like, with a cancer diagnosis, there’s relatively a smooth, smooth prognosis. So I go between.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 20, 2022

How we came about to select these articles or to have interest in this topic is really older adults are unique population that are at risk for both over diagnosis of infections as well as under diagnosis of infections. I think some of that depends on the kind of health system or hospital that you are involved with.

Complication 52

Complication Patient-Centered IT Patients 52

BMJ

MAY 10, 2022

Two hundred seventy-six of the healthcare professionals were reached (response rate: 85.4%). COVID-19 diagnosis of self Yes 24 (44.4) COVID-19 diagnosis of a relative Yes 98 (46.4) COVID-19 diagnosis of self Yes 24 (44.4) COVID-19 diagnosis of a relative Yes 98 (46.4) 150 (54.3) 126 (45.7)

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. Fifty percent have a diagnosis in their record of decedents have dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

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IT Patient-Centered Patients Healthcare 99

GeriPal

AUGUST 29, 2024

So the first thing, explain the diagnosis. Is the sort of task to manage. Gordon 41:13 The hospital is also on fire. I want you to be able to be in the hospital and be with your loved one. Eric 10:36 But I asked Chachi Bt, I said to Chatty BT, I need to tell my patient they have cancer. What should I say? And I want.

IT 132

IT Illness Families Family 132

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. Alex: She’s also associate professor at Massachusetts General Hospital in Harvard Medical School.

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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. For more details, please click here. (AP AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. For-profit hospices having much higher rates of their patients visiting the emergency department and being hospitalized, in addition to disenrollment. I just want to highlight some work. Go ahead, Lauren.

Families 106

Families Family IT Patients 106

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

FEBRUARY 17, 2022

And I was really excited just to learn how to manage these patients, because in the patients in geriatrics clinic that we see, fractures just can be so devastating and result in loss of independence. And so many older adults with diagnosis of osteoporosis have never received any therapy for it. James: Yeah. That has a good ending.

Clinic 67

Clinic IT Patients Medical 67

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? It can help prevent disability, or it can make a diagnosis and that’s it. We know hospital culture influences how we care for our patients.

IT 128

IT Families Family Patient-Centered 128

GeriPal

JANUARY 11, 2024

You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). Alex: Self-administer and psychiatric illness is not considered a qualifying diagnosis. And importantly the patient has to have capacity and they have to be able to take the drug themselves. So they have to self-administer.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable.

IT 83

IT Families Family Illness 83

GeriPal

JUNE 22, 2023

When they built a new prison hospital in Stockton, the dialysis went there. If they need an acute hospitalization, they would be hospitalized in a hospital that we contract with. These older patients are costing a ton in healthcare costs. And the dad just totally lost control, major anger management issues.

Families 132

Families Family IT Community 132

GeriPal

FEBRUARY 16, 2023

Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. In a hospital in the morning, six people wake him up, they got a blood draw, they got everything else. There’s so many elements of a patient that’s hospitalized or going through our medical system.

Patients 109

Patients IT Families Family 109

GeriPal

SEPTEMBER 19, 2024

Alex 00:34 We are delighted to welcome back Jennifer Tem e l, who is a thoracic oncologist at Massachusetts General Hospital in Boston. Within eight weeks of diagnosis of advanced disease. It’s not just about physical symptom management. Eric 26:47 How soon after from a hospitalization, all. Jennifer 00:44 Thanks.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JULY 6, 2023

Started as a direct case manager, worked in a variety of different places including the state legislature and I’ve been with the state office now since 2006. Equally as important, is if you wind up in an ED or being hospitalized or wind up in rehab, eventually you’re going to be discharged back home. Eric: And Susan?

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

MAY 1, 2025

And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. Alex 16:55 My guess is probably not something that most geriatricians or internists or family medicine docs caring for older people have on their differential diagnosis. Is a new diagnosis of HIV.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

JULY 7, 2022

Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. And I wonder as you think about that and as you think about pain being a vital sign, every shift in the hospital people are asking if they’re having pain, we’re going in there asking people, “Are you hurting? Haider: Yeah.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

FEBRUARY 24, 2022

Alex: And we’re delighted to welcome back, a frequent guest to our podcast, Rachelle Bernacki, who’s a palliative care physician and geriatrician at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital. We see our patients and our families throughout the illness trajectory into the hospital.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. We would admit them to the hospital. Who doesn’t want to leave the hospital? What was I doing?

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

JULY 25, 2024

First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? I don’t know how our patients manage that. Liz 00:32 Thanks.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

JUNE 6, 2024

Alex 00:06 We are delighted to welcome back Areej El-Jawahri, who’s an oncologist at Massachusetts General Hospital who specializes in blood cancers. So this is about two and a half, three years out from leukemia diagnosis. Alex 00:03 This is Alex Smith. Eric 00:04 And Alex, who do we have with us today? Don, welcome to GeriPal.

Illness 130

Illness IT Physicals Patients 130

GeriPal

APRIL 21, 2022

Mike Rabow shares his award winning poem about coming out to the world about his diagnosis with multiple sclerosis. . Look also for a forthcoming article by Mike and Redwing in Journal of Pain and Symptom Management on poetry as a healing modality, to be published mid May (will add link when out). Alex: Is that publication out?

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

AUGUST 22, 2024

I love these topics, too, because even how do we define what is a diagnosis? Knowing I was interested in neurology and had opportunities to observe brain death determination in the hospital. So in the case of Jahi McMath, you were talking about, you know, her family was kicked out of the hospital. Alex 04:49 Amyloid.

IT 113

IT Families Family Patient-Centered 113

GeriPal

DECEMBER 21, 2023

This model will give participating programs a per-member-per-month payment to offer care management, care coordination, and other services such as caregiver training, disease education, and respite. I didn’t know how to manage it. But what happened when we finally… When he did get the diagnosis, it all fell into place.

Patient-Centered 125

Patient-Centered IT Families Family 125