GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though. Liz: Right.

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My Green Doctor

JULY 2, 2025

Here we suggest steps that healthcare managers and clinicians can take to protect their patents. We hope you will discover resources to share with your family as well! In the United States, extreme weather events and air pollution are already costing the healthcare system over $820 billion annually.

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Healthcare Healthcare Professional Management Community 52

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. For instance, a family meeting or an update or communication with families. DorAnne 30:25 I also wanna make a shout out for pain and symptom management with social work and chaplains. Eric 31:22 Yeah.

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Screening IT Family Families 119

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. I was really passionate about helping the people and also their families. David: Right.

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Patient-Centered IT Illness Patients 122

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). Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

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Family Families IT 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. And you’re in the ICU family meeting, and it gets heated. Is the sort of task to manage.

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GeriPal

FEBRUARY 22, 2024

They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. 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.

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GeriPal

FEBRUARY 15, 2024

Eric: Well, what are the odds that two family members focus on a similar topic and do research together? laughter] Alex: We love the family theme. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Welcome, Katie, to the GeriPal podcast. Katie: Awesome.

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GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. And I started my career at Barnes-Jewish Hospital in St. But rarely does the podcast and clinical reality meet in the same day.

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GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?”

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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. This is my early father’s day gift from the family. Welcome to the GeriPal podcast, Jennifer. Jennifer: Thanks. Welcome to the GeriPal Podcast, Areej. Eric: Yeah.

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Illness Hospital Patient-Centered Patients 110

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience.

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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. I think for families and for other providers who are not trained in that, it’s very hard to predict.

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GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And so there’s complexity in Understanding how each state manages this. Because I mean, California is different. They have an advance directive.

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Patient-Centered IT Patients Healthcare 109

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay. What is sludge?

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Patient-Centered Hospital IT Illness 116

GeriPal

DECEMBER 15, 2022

So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live. Within the VA it’s now at 70 VA hospitals. Heather: Sure.

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IT Patient-Centered Healthcare Illness 105

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Family member, and with some chagrin- Eric: Powerful nudge. doi: 10.1016/j.pmn.2023.11.004.

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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. And I would say we weren’t doing training on symptom management, for example.

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Telehealth Patient-Centered IT Patients 105

GeriPal

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. . AlexSmithMD .

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Illness IT Family Families 109

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

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Consulting Patient-Centered IT Patients 115

GeriPal

OCTOBER 12, 2023

” Somehow, there’s this signal that the patients and families had to pick up that maybe the surgeon wasn’t so enthusiastic, or if I just dump risk on them, maybe they’ll say, “I don’t want this.” What I need to navigate with that patient and their family, is it valuable to you? Every time.

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IT Family Families Patient-Centered 128

GeriPal

JUNE 22, 2023

When they built a new prison hospital in Stockton, the dialysis went there. In many cases, the families were the victims of the crime. If they need an acute hospitalization, they would be hospitalized in a hospital that we contract with. They can stroll out into… We have a beautiful garden space for family.

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Family Families IT Community 132

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.

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GeriPal

JULY 3, 2025

We’ve invited two palliative care doctors to talk about survivorship with us: Laura Petrillo , a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker , an outpatient palliative care doctor at the Cleveland Clinic. I was there and at University Hospitals, had a great visit. Great to see you guys.

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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. Because I also feel like we target people’s low sodium diets in the hospital. Alex 04:47 Probably was, yeah.

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Primary Care Patient-Centered IT Patients 113

GeriPal

AUGUST 25, 2022

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. As a nurse case manager in hospice, half of my patients had dementia. And I had a blast playing Take the Money and Run! AlexSmithMD.

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Family Families IT Patients 106

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%).

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GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. And, of course, this is what families of patients undergoing palliative care go through. Why did you decide to do this study?

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GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

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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.

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Family IT Families Illness 83

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. Did I get that right? Joel: Oh yeah. Alex: Oh, good. Joel: And they kept her comfortable.

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Patient-Centered Complication Patients IT 101

GeriPal

NOVEMBER 21, 2024

Alex 00:26 And we’re delayed to welcome Amanda Moment, who is a palliative care social worker at the Brigham and Women’s Hospital in Boston. Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? Dani, welcome back to GeriPal. Dani 00:25 Excited to be back.

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. Sue 01:26 Thank you.

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IT Patient-Centered Family Families 104

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. And it’s very traumatic obviously for the family and all of that and the team really.

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GeriPal

SEPTEMBER 12, 2024

Ishwaria 05:29 And that’s really how this field of professional well being, healthcare professional well being, clinician well being, has evolved, is that there is an important place in our overall professional well being for personal resilience and our individual coping strategies, recovery methods from day to day.

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GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

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GeriPal

JUNE 13, 2024

Alex 00:20 Today we’re delighted and honored to welcome Eduardo Bruera, who is one of the biggest symptom management gurus, if not the biggest symptom management guru in palliative medicine. Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. Who do we have with us today?

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