GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? ” and the answer is no, that probably was more just about do you need anybody to support you kind of emotionally or during this hospital stay, just give information to.

Families 97

Families Family Patient-Centered IT 97

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. Joe 31:55 No differences.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JULY 11, 2024

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. Is that, and we try to use, often use the term prognostic humility, that unlike more than any other diagnosis, really, we truly need to be humble, right.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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. Gretchen: It can help you live longer. Surgery does nothing else.

IT 128

IT Family Families Patient-Centered 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? It also feels like, I also grew up in med school in a three hospital system. There’s that recognition piece. Eric: Yeah.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

JANUARY 11, 2024

Alex: Self-administer and psychiatric illness is not considered a qualifying diagnosis. One thing I would like to add here is both Sonu and Leonie presented this as something that lacks boundaries. 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

DECEMBER 19, 2024

* This episode of the GeriPal Podcast is sponsored by the Zuckerberg San Francisco General Hospital Division of Hospital Medicine , which is committed to providing outstanding, compassionate care to all patients, advancing health equity, and fostering excellence in hospital medicine. I think it’s very present in maid.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

AUGUST 31, 2023

Alex: She’s also associate professor at Massachusetts General Hospital in Harvard Medical School. So she had them early in diagnosis and then a little bit later. Alex: She is working in Sweden and researching in Sweden, in Lund. Did I say it right, Lund? Juliet: Lund, yeah. Alex: Lund. Juliet: You got it right. Brad: Yeah.

Illness 128

Illness IT Diagnose Medical 128

GeriPal

SEPTEMBER 1, 2022

I am constantly talking to clinical social workers about what are the ways that you can be contributing to research, to publications, to scholarship, to presentations, even if it’s a reflection paper? What does this diagnosis mean to you? What are the ways that you can tell the story, the practice that you do?

IT 102

IT Family Families Clinic 102

GeriPal

FEBRUARY 16, 2023

Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? It’s just so interesting the myriad of ways that this can present in our behavior when we neglect to just look within. Dani: Yeah, so the way you presented was triggering to them. Keri: Yeah.

Patients 109

Patients IT Family Families 109

GeriPal

JULY 6, 2023

The idea was to create a robust community-based infrastructure that could help older adults succeed in their homes and communities, whether they were healthy, how to keep them healthy or they were at imminent risk of emergency room visits, hospitalizations, or nursing home placements. And that’s critical. Eric: Yeah.

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

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

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? Alex 00:18 Prognosis, super special today. And we have some great guests.

Family 106

Family Families Patient-Centered IT 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

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. Right, my answer that brings us a little bit closer to the present than my childhood. And a lot of my work has kind of been that vein.

IT 113

IT Family Families Patient-Centered 113

GeriPal

MARCH 27, 2025

A real advantage of our study, something that Danny works really hard on, is that that in Maryland we were able to look at these as statewide outcomes and we were able to pull information from the health information exchange to be able to look at whether this happened at any hospital in Maryland. Wait, how is that actually defined?

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

DECEMBER 21, 2023

The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. But what happened when we finally… When he did get the diagnosis, it all fell into place. Malaz: … to restrain them in the hospital. And I was terrified. I didn’t know how to manage it.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

SEPTEMBER 14, 2023

Summary Transcript Summary Hospitals are hazardous places for older adults. These hazards include delirium, malnutrition, falls, infections, and hospital associated disability (which about ⅓ of older adults get during a hospital stay). 2020 Hospital at Home-Plus: A Platform of Facility-Based Care. Annals of Int Med.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 14, 2022

In fact, no one in this hospital died that was not on comfort care. And we now continue to manage all the comfort care patients, which in the setting of a packed hospital, that’s really done some great offloading. We are a community-based hospital. ” Darrell: “Are you coming to the hospital?”

Nurse Practitioner 136

Nurse Practitioner Patient-Centered Vaccination Emergency Room 136

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