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.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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? So I actually was doing a grand rounds as my final presentation here at Yale for my fellowship on the role of music in host pice and palliative medicine. Tyler 01:43 Okay. This guy came alive.

IT 96

IT Patient-Centered Patients Board-Certified 96

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

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. And so when you have that, that’s so good for the family. That’s so good for us.

IT 102

IT Family Families Clinic 102

GeriPal

OCTOBER 12, 2023

I love this series of articles because each presents a component of a practical, patient-centered approach to patient-surgeon communication and decision making, and language surgeons (and surgical trainees) can start using in their next patient visit. What I need to navigate with that patient and their family, is it valuable to you?

IT 128

IT Family Families Patient-Centered 128

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. So what’s amazing about these guidelines, so if you go to 12 different hospitals and ask them, “How are you managing psychiatric conditions and mental health concerns in the context of palliative care?”

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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

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 there are no default pathways of family or friends to rely on and no known people who could potentially represent this person from within their inner circle.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. 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. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3.

IT 137

IT Family Families Physicals 137

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

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

MARCH 28, 2024

Well, as a kick off to this year’s first in-person State of the Science plenary, held in conjunction with the closing Saturday session of the AAHPM/HPNA Annual Assembly, 3 randomized clinical trials were presented. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system?

Consulting 115

Consulting Patient-Centered IT Patients 115

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

MARCH 24, 2022

And especially for those who may have nontraditional families. I think if you’re from a nontraditional family, it’s very important to make sure that people understand who you would want to talk to. We also saw a lot of conflict in families because of that. Bob: So I think it’s important. Rebecca: Agreed.

Illness 72

Illness IT Healthcare Patient-Centered 72

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 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. And love that Jim Croce choice.

IT 104

IT Patient-Centered Family Families 104

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. But if we’re going to have a family meeting, that’s a different circumstance. What are you seeing in terms of the relationship between this patient and their family?

Illness 125

Illness IT Patient-Centered Patients 125

GeriPal

SEPTEMBER 21, 2023

Fayron: I think I was interested in family caregiving early on because I had it in my family, but it wasn’t until my postdoc days when I was writing my application that I needed to narrow it down. Those are the things that Black family caregivers that I’ve been working with go through. Fayron: Yeah. Alex: Oh, sorry.

Community 128

Community Family Families IT 128

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? 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.

Patients 109

Patients IT Family Families 109

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. These studies are important. LaVera: Yes. Absolutely loved it.

IT 99

IT Patient-Centered Family Families 99

GeriPal

NOVEMBER 14, 2024

I think there’s a few studies in dialysis patients and in hospitalized patients suggesting that gabapentin and pregabalin is associated with an increased risk of falls. I like there was some work from Mary Tonetti’s group looking at a large sample of hospitalized patients with injurious falls and their antihypertensive use.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

FEBRUARY 13, 2025

Summary Transcript CME Summary In todays podcast we were delighted to be joined by the presenters of the top scientific abstracts for the Annual Assembly of the American Academy of Hospice and Palliative Medicine ( AAHPM ) and the Hospice and Palliative Medicine Nurses Association ( HPNA ). I’m a PhD candidate at Yale School of Nursing.

Consulting 63

Consulting Community Patient-Centered Family 63

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

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.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

OCTOBER 5, 2023

I felt like I was always told to present people with a buffet of options and, really, without guidance, ask them to choose, which is, it would always make me feel sick to my stomach. So I first want to just say thank you to Ernesto’s family. This is Eric Widera. Alex: This is Alex Smith. Eric: And can you tell me about Ernesto?

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

MAY 29, 2025

Today we talk about lucid episodes and what they might mean to the person with dementia, their family and loved ones, to philosophers, to clinicians, to neuroscientists. Particularly patients, families. Alex 06:05 And, oh, for that family, it was so meaningful. That their loved one is in there. Eric 01:34 Yeah. Eric 06:07 Yeah.

Family 93

Family Families IT Patient-Centered 93

GeriPal

NOVEMBER 2, 2023

I was very close with my grandparents growing up, and then I actually was exposed to geriatrics as a pre-med student at Yale New Haven Hospital as one of the volunteers and Dr. Sharon Inouye’s initial help trial and had a fabulous role model Dr. Verano, who I wanted to be. Ryan: Actually, a very similar story as to Jerry.

Board-Certified 91

Board-Certified IT Community Medical Student 91

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. So then you drill down further, just like you said, Eric, when you were going back between different hospitals. Eric: Yeah.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

MAY 25, 2023

Summary Transcript Summary Our guests today present an important rejoinder to the argument that we should refocus away from advance care planning (ACP). Health care system drives where you end up, which hospital, which state you live in. And that family was not necessarily a trusted network.

Community 95

Community IT Patient-Centered Primary Care 95

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

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. Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

NOVEMBER 17, 2022

AlexSmithMD (still on Twitter at present). I mean, people who used to be in hospitals are now with quicker DRGs. So, the top two were that assisted living communities, in those communities the resident should be present during assessment and care planning. Or do you want to go to the hospital if something happens?

Community 97

Community IT Mental Health Medical 97

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. He was a person with schizophrenia, he was a person who used drugs and he presented in pain crisis to our shelter. Today we talk with Naheed Dosani, a palliative care physician at St.

Healthcare 100

Healthcare IT Community Illness 100

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

DECEMBER 5, 2024

Alex 00:23 All right, first, we’re welcoming back Ricky Le it er, who’s a palliative care doc at Dana Farber Cancer Institute in Brigham Women’s Hospital and Harvard Medical School and is co-founder of the Palliative Story Exchange. Ricky, welcome back to the GeriPal Podcast. Ricky 00:38 Great to be back. Ricky 11:23 Yeah.

IT 107

IT Community Patients Families 107

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. They may have few family members, live alone. You just knew it? Thomas: Yeah, yeah.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

JANUARY 20, 2023

The technology committee however, is interested in using technology and coming up with a new set of goals, priorities and preferences and basing the process on working with nursing home residents, care partners or family members if they’re involved. It needs to be presented in a way that they can understand.

Finance 95

Finance Board-Certified IT Provider 95