GeriPal

JULY 27, 2023

I think the classic example is somebody who just came out of the hospital, they’re put on these new medications because they were having problems in the hospital and now they’re home and they don’t need those anymore. And then you get the call from the family, they can’t sleep at night. Cathy: Well, yeah.

Illness 85

Illness IT Clinic Medical 85

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. 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.

Community 114

Community Transportation IT PCP 114

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.

Family 102

Family Families IT Diagnosis 102

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. But rarely does the podcast and clinical reality meet in the same day. Therapists are so much more. Ann, welcome to the GeriPal podcast.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. For instance, a family meeting or an update or communication with families.

Screening 119

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. Eric: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. So it’s a lot, but it’s good.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. I mean, to me, the Buddhist concept that there are multiple forms of suffering, like there’s the suffering that’s due to pain and physical symptoms. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004. 2023.11.004.

IT 137

IT Family Families Physicals 137

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?”

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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? A music therapist would use music deliberately to achieve a rehabilitation goal, just like a physical therapist or an occupational therapist. Eric 01:41 Tyler, why’d you choose this song?

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. 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.

Illness 110

Illness Hospital Patient-Centered Patients 110

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.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

FEBRUARY 22, 2024

A lot of those symptoms of depression can also be attributed to different kinds of physical symptoms. They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. A lot of times I see private sector hospitals saying, “We have mental health covered.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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.

IT 128

IT Family Families Patient-Centered 128

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 Family Families Illness 83

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. When they built a new prison hospital in Stockton, the dialysis went there. They suffered from it.

Family 132

Family Families IT Community 132

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

JULY 11, 2024

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. I’m embedded in the ICU in one of our smaller hospitals. You still want to go to the hospital if you get sick?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. I was just thinking back to yesterday, we were in a family meeting.

IT 145

IT Hospital Patients Illness 145

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

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. It’s what I know.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

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.

Consulting 115

Consulting Patient-Centered IT Patients 115

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.

IT 104

IT Patient-Centered Family Families 104

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. A pill organizer, having family.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Rehabbed to Death.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. Healthcare industry cannot do it.

Community 115

Community IT Relationship Healthcare 115

GeriPal

OCTOBER 5, 2023

So I first want to just say thank you to Ernesto’s family. And I met with his family over Zoom, which was how many of us had to meet with families during that time. We were doing a lot of this without a whole lot of guidance, as is common, I think, from family, because all they knew was who he was. Sunita: Yes.

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

APRIL 6, 2023

On the other hand, all of our guests agree that chaplains are often the most vulnerable to being cut from hospital and health system budgets. These hick pick codes are available to any chaplain in a healthcare system. LaVera: I trained at UCSF in family medicine. They followed them during the course of their hospital stay.

IT 99

IT Patient-Centered Family Families 99

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? And countertransference is everywhere.

Patients 109

Patients IT Family Families 109

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?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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?

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

MAY 26, 2022

Emily: And so even in the pandemic, we’ve seen circumstances like this where hospitals wrote allocation policies that were going to give preference to frontline healthcare workers in hopes, right, that they would incentivize them to stay on the job knowing that they would be taken care of and because they had been working for the public good.

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

FEBRUARY 9, 2023

It also feels like, I also grew up in med school in a three hospital system. There’s the variation between the hospitals, feels like there’s cultural issues that play a role. They look at the signs and symptoms, they do a physical exam, maybe some lab tests or some imaging. Eric: Yeah. And so have some of my mentees.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

SEPTEMBER 22, 2022

And in response, the family or patient looked at you like you were from another planet? Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. Links: – Uncanny Valley post on Josh’s fantastic substack Notes from a Family Meeting.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

JUNE 13, 2024

Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. And the truth is we don’t want, I don’t want any patient or family to perceive that when Brera goes to see me, there’s a second interest, a second gain. Alex 24:58 I’m so glad you mentioned the family.

Illness 133

Illness Patient-Centered Patients IT 133