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. We provide critical conversations with colleagues and families to coordinate transition planning.”

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

MAY 15, 2025

We didn’t make them communicate it, but we focused them on it, which makes them more likely to then utilize that information. And so we simply asked clinicians, have you offered this patient and, or their family the option of care focused on comfort? Their family members want them to get out of the hospital sooner.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

FEBRUARY 13, 2025

And so it was really the patients, you know, the caregivers, the family members were the ones who were sort of the closest in observing. Later on, of course, we added health professionals to, you know, give us more information. And my community and about my family and those kinds of things. Our consultation. Marie 11:03 Yes.

Consulting 63

Consulting Community Patient-Centered Families 63

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. Karl: Okay. Karl: You can write it in. That’s part of why that not part of the form, right?

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

APRIL 6, 2023

That’s why we use the terms assessment and intervention and we think of assessment as a skill of a very advanced skill that chaplains have of doing an in-depth evaluation of a patient or family member, and then the interventions should certainly follow naturally from that. LaVera: I trained at UCSF in family medicine.

IT 99

IT Patient-Centered Families Family 99

GeriPal

JUNE 9, 2022

But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. And I actually think the cool thing about a needs-based approach would allow us to better utilize the service.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

APRIL 28, 2022

Here’s another clinician saying, “I ignored a patient’s tears and gave a speech about cardiac physiology during a family meeting.” I was just thinking back to yesterday, we were in a family meeting. I think it was just sort of commentary that I had running in my head about what is the real utility of this radar?

IT 145

IT Hospital Patients Illness 145

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. John: I am what I am, which is a family practice doctor. ” I think the family would like you to consider how to work with that. That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

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. And the technology piece, so doing less with staff.

Finance 95

Finance Board-Certified IT Provider 95

GeriPal

FEBRUARY 2, 2024

And, of course, this is what families of patients undergoing palliative care go through. Eric: Utilization, utilization, utilization. Those two things together, no increase in mortality but increase in hospice utilization, it doesn’t prove that palliative care is goal-concordant, but it’s certainly suggestive.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

JUNE 5, 2025

Kathleen 03:47 I think any of us who’ve spent any time in nursing homes have spent time working in a nursing home setting, have visited, had family members in nursing homes and looked around and seen the population there. So we see a lot of problems with symptom management, a lot of family conflict. That’s a big question.

Referral 78

Referral Nurse Practitioner Consulting Board-Certified 78

GeriPal

MARCH 28, 2024

I am part of some other work in the ICU world looking at time-limited trials and trying to better define what those are, how we talk about them, how we talk about them with patients and families. It makes patients and families feel better and outcomes better and quality of care better, and we can implement it.

Consulting 115

Consulting Patient-Centered Patients IT 115

GeriPal

APRIL 14, 2022

But that just didn’t really resonate with what I saw clinically which was that there was lots of suffering both in the patient, their family and on the clinical team and just felt it was really this space where I didn’t have a lot of evidence to guide me. Don’t worry about their alcohol use or drug use. Give some pleasure.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

APRIL 10, 2025

It was really at the level of the ED across 33 EDs in random order, and then tried to see if we could make a difference in healthcare utilization, primarily the primary outcome was admission to the hospital, acute care admission. And it’s very traumatic obviously for the family and all of that and the team really.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

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. But once I got into medicine, I found myself attracted to the field of psychiatry.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

DECEMBER 19, 2024

So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families? There’s a Boguts case, a patient with anorexia who utilized medical aid and dying. Eric 05:46 So I got a question. Which is very quick, clearly labeled six months or less.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JULY 6, 2023

Administration on Aging connecting you to services for older adults and their families California’s Master Plan for Aging New York’s Master Plan for Aging Transcript Eric: Welcome to the GeriPal Podcast. This is reaching the highest utilizers with a wraparound suite of services. This is Eric Widera. Alex: This is Alex Smith.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

SEPTEMBER 19, 2024

So, basically, with a stepped care model, the goal is to tailor care delivery to the patient’s needs while at the same time utilizing less clinician resources. There was a difference, though, in hospice utilization, right? So I don’t know how clinically meaningful that week difference was to families.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. It’s hard for your family to know. So one that the primary outcome was supposed to be documentation, which it improved documentation, it wasn’t powered to actually look at any utilization or hard outcomes. [laughter].

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

JUNE 26, 2025

We focus on function and mortality because these are outcomes that really are important to patients and families. And it was her conceptual, like incorporation of functional decline, some measure of functional decline along with a serious illness diagnosis that you’re utilizing here. What is your function? And do you die?

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JULY 13, 2023

” And I saw Randy run family meetings before I knew he was famous, before I knew he was this legendary researcher. And he was just such a great doctor and such a great advocate for families. Should it be decreased utilization, decreased use of CPR? And the guy was just so good. He really practiced what he preached.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

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.” Malaz: I love it.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

JULY 20, 2023

We were the highest utilizers of telemedicine in the whole UCSF health system at that time which we’re very proud of. I think you’re a loving family doing the best you can.” I think at least we like to think of ourselves as ahead of the curve. They couldn’t get a case manager to refer them in palliative care.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73