GeriPal

FEBRUARY 6, 2025

On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. He is associate professor at the University of Wisconsin and medical director of their Alzheimer’s Disease Research Center. Nate 00:25 Thanks for having me.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. But really those urinary tract signs and symptoms should be driving your diagnosis.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Guests Alex Gamble and Brianna Williamson have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

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. But watch out! Travel time can leave this champ vulnerable to fatigue and no-shows.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. Katie, welcome back to GeriPal. Jessie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening IT 136

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. Des delivered a plenary at this year’s National Palliative Care Research Center’s Foley retreat. That rings true to me. All hands go up. All hands go down. Des: Thank you so much.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

APRIL 14, 2022

Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Management of chronic pain in the elderly: focus on transdermal buprenorphine. And how am I going to manage their pain? Learn about using the low dose buprenorphine patch: . Learn about how to initiate buprenorphine: .

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 96

IT Patient-Centered Patients Board-Certified 96

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? And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. They just kept at it.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. Kirsten 04:16 So, in emergency medicine, obviously, we are interacting and caring for these both exciting and interesting, but also very complex and humbling patients to care for in the ED setting. What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. When I see a patient? Matthew, I get the lyrics.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 15, 2023

Alex: And we have Matt DeCamp, who’s joining from the University of Colorado, where he is a primary care internist and bioethicist at the Center for Bioethics and Humanities. My worry though with that is that are we going to be expected to be more productive then, to see more patients? The patient is crying in front of you.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Who follows the patient once the cancer goes into remission? Why am I having difficulty with this patient? Why am I feeling frustrated with this patient?

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

JULY 28, 2022

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. Eric: And what a research agenda that you’ve done, including one of the most seminal papers that we have in palliative care in lung cancer patients.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

AUGUST 17, 2023

However, as noted in our editorial published with the donanemab trial , the modest benefits of amyloid antibodies would likely not be questioned by patients, clinicians, or payers if amyloid antibodies were low risk, inexpensive, and simple to administer. However, they are none of these. Welcome back to the GeriPal podcast, Jason.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

FEBRUARY 29, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she be treated non-operatively, with aggressive symptom management? And there’s been some recent research specifically about in fractures for patients that are very frail or have dementia and it’s sort of the same thing.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JUNE 19, 2025

And also kind of highlights, you know, part of what we try to do in geriatrics and palliative care is really individualize how we care for individual, like, the people in front of us, the patients, the caregivers, their family members, their friends. And then the other thing is really partnering with your patient or your clients in terms of.

Individual 85

Individual Community IT Chronic Condition 85

BMJ

MAY 10, 2022

Family health centers are the facilities where the vaccination intention is much more vital, as they carry out the contact and case follow-ups during the pandemic and are the center of vaccination application. There are 44 family health centers, including 158 family physicians and 165 family health workers working in the district.

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. I did it before and this guy, he was 85, but he was climbing Mount Everest.”

IT 128

IT Family Families Patient-Centered 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

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage). Leonie, welcome to GeriPal. Leonie: Thanks for having me.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 7, 2024

Whenever I take care of a patient, I see myself as a family practice doctor, but I’ve been a hospitalist, I’ve been a primary care doctor, and I’ve done palliative. But in the end, I see these as my patients and I’m trying to define what is the right model. I wonder, is this only for patients in hospice?

Provider 117

Provider Illness IT Healthcare 117

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

MARCH 20, 2025

Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self?

IT 87

IT Patient-Centered Patients Medical 87

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

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. It could be in housing, it could be a standalone senior center, home delivered meals, nutrition counseling and nutrition education done by registered dieticians.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 7, 2022

Haider: And because it is so subjective and because we have these arbitrary rules around what the right patient with pain looks like, I think we really trap patients in a really difficult situation. One of the patients I spoke to really said this quite well. And yet very, very few patients are actually using those services.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. It is appropriate for all patient populations, and it is developed specifically for the palliative care and hospice populations. Why do this?

Family 106

Family Families Patient-Centered IT 106

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Mike Rabow shares his award winning poem about coming out to the world about his diagnosis with multiple sclerosis. . Alex: We also have Mike Rabow, who is director of palliative care at the Cancer Center at UCSF.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. And maybe we should have more patient-centered conversations. We want to do meaningful work and so we want to know that the conversations we have impact patient care. That this is iterative from diagnosis to end-of-life, right?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). I’m hearing dementia patients or patients with dementia. Eric 09:15 And then who were the patients just with dementia or were they. Is that right?

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

DECEMBER 1, 2023

In particular we spend a good deal of time talking about what this means for asymptomatic patients who may have an abnormal biomarker, which by the proposed new definition would mean they would now have Alzheimer’s disease. Alex: We have an all-star cast. Heather, welcome to the GeriPal podcast. Jason, welcome back to GeriPal.

IT 115

IT Clinic Illness Hypertension 115

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.” Care Ecosystem.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

AUGUST 22, 2024

I love these topics, too, because even how do we define what is a diagnosis? And then another, which was released under the Bush administration by a council with a different sort of philosophical Benton worldview which still managed to come to the same conclusion in support of a brain based definition, death. Alex 04:49 Amyloid.

IT 113

IT Family Families Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115