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. But individuals who have hearing loss, there’s several problems. Is that right?

IT 102

IT Screening Hospital Clinic 102

GeriPal

JUNE 8, 2023

Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? 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.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Illness 136

Illness Patient-Centered Screening Clinic 136

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.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Katie, before we jump into the topic of buprenorphine in serious illness, what’s the song request?

Illness 102

Illness Patient-Centered IT Patients 102

Doctors for America

JUNE 30, 2025

Medicaid provides care for low-income families, people with disabilities, children, the elderly, and pregnant people, as well as many safety-net hospitals, community health centers, and nursing and long-term care facilities. How Are Income and Wealth Linked to Health and Longevity (Urban Institute and Center on Society and Health, Apr.

Healthcare 59

Healthcare Community Family Families 59

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

AUGUST 31, 2023

Summary Transcript Summary How do people react when they hear they have a serious illness? And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness. Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).

Illness 128

Illness IT Diagnose Medical 128

The Clinical Problem Solvers

MAY 2, 2022

Dr. Valtis is a 4th year Med-Peds Resident at Brigham & Women’s Hospital and Boston Children’s Hospital, and his research focuses on race and the utilization of security responses in the inpatient hospital setting. Yannis Valtis, Ebi Okah, and Carine Davila, about research in their respective fields.

Healthcare 52

Healthcare Utilities Hospital Internal Medicine 52

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. So I first want to just say thank you to Ernesto’s family. This is Eric Widera. Alex: This is Alex Smith. Eric: And Alex, who do we have with us today?

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. Should you stop at “no?” We will have to reach out to your daughter then to help with decisions.

Family 97

Family Families Patient-Centered IT 97

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? For more details, please click here. (AP AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

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

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Transcript. This is Eric Widera.

Illness 110

Illness Hospital Patient-Centered Patients 110

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). Love to talk about also in the serious illness population. “Do you guys do this?”

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. 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 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. Participants were critically ill and intubated. What is sludge? The prognosis nudge did nothing.

Patient-Centered 116

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. Tell me about your illness. How did you get into this? Heather: Sure.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Family 112

Family Families Patient-Centered IT 112

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.

Family 83

Family IT Families Illness 83

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. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended? Is that fair?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . And especially for those who may have nontraditional families. This is Eric Widera.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

JUNE 30, 2022

Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. And she was rushed to the hospital. Did I get that right? Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. 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. Sammy: Thank you so much.

Education 127

Education IT Illness Healthcare 127

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. When should people get palliative care? What is a pragmatic trial ?

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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! Good to know.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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

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. I think, again, it’s the person’s individual, their preference. Alex: Yeah, I like that approach too.

Community 128

Community Family Families IT 128

GeriPal

JUNE 22, 2023

But now we have older people dying of older people illnesses. Alex: And are the regulations similar or different in terms of six month required prognosis or less, should the disease take its usual course, or illnesses leading to a short prognosis? When they built a new prison hospital in Stockton, the dialysis went there.

Family 132

Family Families IT Community 132

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. by Kearney. Lovely to be here.

IT 104

IT Patient-Centered Family Families 104

GeriPal

JULY 11, 2024

We get a bit of, in the veteran population, kind of a mix of a lot of mental health issues thrown into these comorbid illnesses, including cirrhosis, but it’s usually the decompensated cirrhotics or the folks with liver cancer and cirrhosis, or one of both. I’m embedded in the ICU in one of our smaller hospitals.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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. The patient refuses to ever talk about the fact that this illness could take their life.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. But that was separate from MAID.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. The illness narratives suffering, healing, and the human condition. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3.

IT 137

IT Family Families Physicals 137

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. In fact, as Lauren Hunt found , the average likelihood that a person will be disenrolled from one hospice vs. another is two.

Family 106

Family Families IT Patients 106