GeriPal

DECEMBER 2, 2022

So on today’s podcast we invite four brilliant individuals to talk about their perspective on how to change how we as a society and health care system partner with individuals with dementia. She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

JUNE 8, 2023

So my background clinically is working with cancer patients and families and those who underwent bone marrow transplant, and a lot of times for their treatment regimen, it includes steroids. What is the role of the family caregiver system, how they play a role? Tamryn: Yes, 100%.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JULY 19, 2024

What should we use to screen individuals? Alex 00:20 And she’s professor of family medicine at USC, deputator at JAGS, and co lead of the bold center of Excellence in early detection of dementia. Well, because they’re hard on people with dementia and they can be very hard on families, and they’re a form of crisis.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MAY 11, 2023

I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. Physical activity is a big one. One might argue they still are. So, that’s how I ended up there. That’s really falling apart.

Physicals 85

Physicals IT Hypertension Education 85

GeriPal

MAY 5, 2022

We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. Communication techniques we can use when talking to individuals with hearing loss. And one of the parts of that was actually doing physicals for the students and putting them in job placements.

IT 102

IT Screening Hospital Clinic 102

GeriPal

JUNE 19, 2025

Noelle Marie 01:24 I think it really speaks a lot to my own personal journey and I’m pretty sure a lot of trans and gender diverse individuals also resonate with and it really speaks about our transition, celebrating our authentic selves, how society views us and how we view ourselves when we stand in front of a mirror.

Individual 85

Individual Community IT Chronic Condition 85

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). Were those people self referring, or family members calling you asking? Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

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

FEBRUARY 8, 2024

So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? I think there is a difference, too, between physical suffering, and we have to also give that its dignity.

IT 137

IT Family Families Physicals 137

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. So I think it’s a bit of both acknowledging it and the emotion that may be in the room, but also just seeing the family. Alex 19:04 Yep.

IT 132

IT Illness Family Families 132

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

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. Tamra: I wrote this… Eric: Thinking that the perceived role for inpatient physical therapist is a discharge consultant.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. I was really passionate about helping the people and also their families. Eric: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . 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.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. You’re recognizing that, wow, this could happen to me, and I wonder sometimes about the challenges.

IT 83

IT Family Families Illness 83

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

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

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. In many cases, the families were the victims of the crime. Michele: Yeah. We have that. Alex: Mm-hmm.

Family 132

Family Families IT Community 132

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. And so I really gain that and I love the chorus words that she uses in this song.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JULY 11, 2024

I think for families and for other providers who are not trained in that, it’s very hard to predict. As this patient has an x percent mortality in three months, there’s a little more nuance to it, and it isn’t really applied to the individual. I could imagine that could lead to conflict. Amy 24:21 For me, I always.

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. But we’re not perfect individuals.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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. I would say that.

IT 99

IT Community Patient-Centered Medical 99

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

FEBRUARY 29, 2024

Eric: I do not want my family to listen to my podcasts. So, I generally don’t listen to the podcast afterwards, nor force them on my family. We’re willing to spend $50,000 a year for individuals for their expensive pharmacy medication. Alex: We are only on the fourth of 10. They ordered mild to hot. Alex: Thank you.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. That was the patient and the family were of equal importance.

IT 104

IT Patient-Centered Family Families 104

GeriPal

MARCH 2, 2023

I also heard that if you look at all individuals in the US, about 4% of individuals are taking one of the gabapentinoids, 10% over 65. One in five individuals with dementia and behavioral problems are on valproic acid and the evidence base for valproic acid for dementia behavioral issues is really zero.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

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

FEBRUARY 20, 2025

Kate and Ashwin talked about their research on the prevalence of lifetime trauma and its association with physical and psychosocial health among adults at the end of life. And you can’t really predict how each individual might react to the same experience. Some of them are really deeply individual experiences.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

APRIL 6, 2023

Chaplains can do an assessment of the spirituality of the individual and then they use interventions that are part of their discipline and those interventions are tailored to the individual’s spiritual and religious needs of the person that they’re caring for. LaVera: I trained at UCSF in family medicine.

IT 99

IT Patient-Centered Family Families 99

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. 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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right. Jennifer: Oh nice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 16, 2022

Alex: Today we are delighted to welcome Chrissy Kistler, who is a geriatrician researcher in the Department of Family Medicine and Vision of Geriatrics at the University of North Carolina, Chapel Hill. The family asks you for an antibiotic and their goals are limited additional interventions. Alex: This is Alex Smith. Chrissy: Yeah.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

JUNE 29, 2023

And back then, mostly we took care of each other in the cells and it was like a family thing. AIDs didn’t know any color or creed, so it was a family thing, we all took care of each other. I am there with individuals who are dying. And it’s a family environment, it becomes like a big family here.

IT 97

IT Family Families Board-Certified 97

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

MAY 12, 2022

What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. Raj: 40 years later in 2018, they got together at Astana, the then capital of Kazakhstan, and brought out another resolution, which ask member countries to give control over healthcare to the community. Healthcare industry cannot do it.

Community 115

Community IT Relationship Healthcare 115

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. And this is really traumatic event for his street family and the street community that he knew. those experiencing homelessness).

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Had multiple physical, psychological complications as a result of that.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

FEBRUARY 6, 2025

And then the family tells me they can’t keep an appointment, they can’t manage their finances. Well, even for somebody like you, who’s pretty familiar with the instruments, it might cause distress for the patient, maybe their family. So it matters a lot to the person, to their family, to the community.

Primary Care 95

Primary Care Diagnosis Screening IT 95