GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Because I might be able to cope and manage in one situation with the skills and supports that I have, and with those same skills and supports, and another situation kind of come unraveled. Great to be here.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

NOVEMBER 21, 2024

Coping in the setting of serious illness. Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? Should I laugh at that? So you just published not too long ago.

Illness 125

Illness 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 . Management of chronic pain in the elderly: focus on transdermal buprenorphine. Transcript. Right, Katie?

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex: This is Alex Smith.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. This is Eric Widera. Alex 00:12 This is Alex Smith. So we got a lot to cover.

Management 116

Management Patient-Centered Patients IT 116

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

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. Eric 00:14 And Alex, this one’s been a long time in the making.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Eric 01:42 So we’ ve got an exciting topic today.

IT 132

IT Illness Family Families 132

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

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

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. We had tried to actually select people who didn’t have a serious illness. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me. Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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.,

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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. Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

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.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

AUGUST 11, 2022

In particular, she reminds us that when we think about the most challenging of our patient encounters, they almost always involve a complex psychosocial dynamic, and this has received far less attention than communication and symptom management issues. . – Serious Illness Conversation Guide podcast. AlexSmithMD .

Illness 109

Illness IT Family Families 109

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?

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. And I would say we weren’t doing training on symptom management, for example.

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 so there’s complexity in Understanding how each state manages this. Because I mean, California is different. Is that fair?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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

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.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 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. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. I think for families and for other providers who are not trained in that, it’s very hard to predict. I could imagine that could lead to conflict. Eric 24:21 Is it any different than other diseases?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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. Alex: And, it means pain management.

IT 126

IT Patient-Centered Illness Education 126

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. As a nurse case manager in hospice, half of my patients had dementia. And I had a blast playing Take the Money and Run!

Family 106

Family Families IT Patients 106

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? 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? She has advance dementia. Eric: So, let’s talk about that. So, decision-making and surgical procedures.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. And this really allowed, I think, other people to celebrate themselves and the families, family members who are going through the same type of journey. Happy pride and thanks for the invitation, Alex and E.

Individual 85

Individual Community IT Chronic Condition 85

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.

Family 132

Family Families IT Community 132

GeriPal

DECEMBER 14, 2023

On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. And it was amazing just seeing the differences in how end-of-life care is managed at those three institutions, which were all a subway right away from each other.

Hospital 125

Hospital IT Patient-Centered Patients 125

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

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience. And it was like the lights came on.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JUNE 15, 2023

Because the in serious illness care and care for older adults, their care is often very complex. And patients and family members tell us that they worry that their clinician is going to be overly focused on that mortality number now. Matt: I think you’re also… Go ahead. Charlotta: No, I totally agree with Sei.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

OCTOBER 24, 2024

If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? They want to be able to manage their own symptoms. But you really should be looking at family history, personal history. Eloise, welcome to the GeriPal podcast.

Medical 98

Medical IT Patient-Centered Healthcare 98

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. So we’re going to be today talking about serious illness palliative care in the homelessness population.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 12, 2023

” Somehow, there’s this signal that the patients and families had to pick up that maybe the surgeon wasn’t so enthusiastic, or if I just dump risk on them, maybe they’ll say, “I don’t want this.” What I need to navigate with that patient and their family, is it valuable to you? Every time.

IT 128

IT Family Families Patient-Centered 128