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.

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Illness Patient-Centered Screening Clinic 136

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?

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Illness Patient-Centered IT Nurse Practitioner 102

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).

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Illness IT Diagnose Medical 128

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. Eric: And can you tell me about Ernesto? Sunita: Yes.

Illness 136

Illness IT Patient-Centered Family 136

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.

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IT Illness Family Families 132

GeriPal

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. To note that I am an individual who goes through this world. I face a lot of different stressors and challenges similar to other individuals, but I also have my own unique experiences. Noelle Marie 01:15 I do.

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Individual Community IT Chronic Condition 85

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? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 101

Illness Mental Health IT Patient-Centered 101

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?” AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

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Family Families Patient-Centered IT 97

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.

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Patient-Centered IT Illness Patients 122

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. Eric: Yeah. Alex: Yeah.

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Family Families IT Diagnosis 102

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse-based education to increase understanding of the spiritual dimension in healthcare. It’s since spread to over 70 VAs. Bennett, C.R.,

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Patient-Centered Illness Healthcare IT 115

GeriPal

MAY 4, 2023

There’s all this stuff that we’re supposed to be doing at that stage of life and then you add the complexity of the serious illness. It is really difficult for the patients and the families. Young adulthood is super hard. Daniel, does that play a role as far as… I have a 14-year-old son. Thoughts on that?

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IT Family Families Illness 83

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.

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Illness IT Healthcare Patient-Centered 72

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?

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Patient-Centered IT Patients Healthcare 109

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.

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IT Family Families Clinic 102

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.

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Education IT Illness Healthcare 127

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.

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IT Patient-Centered Healthcare Illness 105

GeriPal

MARCH 9, 2023

Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). And some people in studies and just in clinical use have found that to be helpful, including for patients with serious illness.

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Patient-Centered Community IT Medical 91

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.

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Community Family Families IT 128

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Transcript. Eric: Yeah.

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Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 29, 2024

Not the most common circumstances that people with serious illness face where attention and understanding of what my goals and values are. 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. ” Very specific, rare circumstance.

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IT Patient-Centered Illness Education 126

GeriPal

APRIL 4, 2024

If they didn’t do it all by themselves, they talked to the family and it was a conversation, but also there wasn’t a whole lot that doctors can do then. What words to use? Is the POLST useful? Under what circumstances? Should we abandon the term, “comfort measures?” Bernie: Well, there was a time when doctors made these decisions.

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Family Families Patient-Centered IT 112

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.

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IT Healthcare Healthcare Professional Patient-Centered 110

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.

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Telehealth Patient-Centered IT Patients 105

GeriPal

JUNE 30, 2022

Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? Welcome to the GeriPal podcast, Samir. Samir: Thanks, Alex and Eric.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. 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”? Pain Manag Nurs. doi: 10.1016/j.pmn.2023.11.004.

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IT Family Families Physicals 137

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 so I knew that I wanted to do something related to palliative care because I work with people with advanced and serious illness.

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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. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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? In many cases, the families were the victims of the crime. Eric: Mm-hmm.

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Family Families IT Community 132

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.

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Illness IT Medical Provider 144

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. He looked very ill. John: I am what I am, which is a family practice doctor. I’m unsure what they do, how often they’re used, and who pays for their work.

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Provider Illness IT Healthcare 117

GeriPal

MAY 25, 2023

And, you know, I really leaned in from my perspective as a primary care geriatrician to hearing from what my patients and their family caregivers are asking me for and asking me about, and they’re asking me about how they can prepare. And that family was not necessarily a trusted network. Alex: LJ, are you going to add to that?

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Community IT Patient-Centered Primary Care 95

GeriPal

JUNE 9, 2022

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. But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. What does “early” really mean?

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Consulting Patient-Centered Diagnosis Referral 99

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. And it’s usually those people that I’m seeing.

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Patient-Centered IT Patients Clinic 109

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.

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IT Patient-Centered Family Families 104

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. It’s really a pretty traumatic experience for a lot of patients and families. AlexSmithMD. Transcript. Melissa: Sure.

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Family Families IT Patients 106