GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JUNE 5, 2025

The obstacles hindering referrals to palliative care services. We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice. So we see a lot of problems with symptom management, a lot of family conflict.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

JUNE 9, 2022

Should eligibility and access be determined by clinician referral? If we move away from clinician referrals as the means by which people get access, how do we keep the clinicians engaged, and not enraged? But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. The family meeting.

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

GeriPal

JULY 11, 2024

Eric 07:08 Which of the patients that you think you’re helpful for, you want referrals? Eric 11:05 So is there a trigger or what’s your referral criteria for the outpatient clinic? I think for families and for other providers who are not trained in that, it’s very hard to predict.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JUNE 22, 2023

In many cases, the families were the victims of the crime. If the community hospital isn’t able to provide a service like tertiary care, oncology care, they would get a referral to UCSF or wherever, just like anybody in the community. They can stroll out into… We have a beautiful garden space for family.

Family 132

Family Families IT Community 132

GeriPal

FEBRUARY 15, 2024

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. So one of the big pieces of this is that idea of a referral at a second time when they’re less overwhelmed and stressed to figure out what happened. It works really well for us.

Community 115

Community Transportation IT PCP 115

GeriPal

FEBRUARY 22, 2024

They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. I’m having family meetings to talk about goals of…” They have so many competing demands that you ask, “Do you do any 30 to 45 minute counseling sessions on a regular basis?

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

JANUARY 18, 2024

Have you had a family history of substance use disorder? Should it just be referral to their PMD, who’s all, “Why are these people telling me to do all this stuff all the time?” And they ask questions like, have you used substances? Most of our population has trauma. But alcohol and opioids are up there.

Illness 136

Illness Patient-Centered Screening Clinic 136

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 Family Families 99

GeriPal

MARCH 6, 2025

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. 80% died exactly where they wanted to and 83% were reconnected to family or friends through a psychosocial support system that we put into place.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 17, 2024

If it’s continuing and it’s getting worse and maybe they have some swelling in the legs, there are some subtle findings on the echo, but really think for a second, could this be this really common cardiovascular condition, echocardiogram, maybe even a referral to a cardiologist? A pill organizer, having family.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

FEBRUARY 6, 2025

So I get all the referrals from my great colleagues in primary care. 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.

Primary Care 96

Primary Care Diagnosis Screening IT 96

GeriPal

MARCH 10, 2022

The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. Whereas the home with the low rate of feeding tube use involved families in decision making. So we looked at hospital referral regions, and we looked at high- and low- intensity regions. There was a hesitancy to engage black families.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

OCTOBER 6, 2022

.” The assumption for most of these focus group members was that medicine is a business, that there are incentives that physicians and other clinicians are responding to that are not transparent, and that decisions are being made that are in the interests of the health system, not in the interest of the patient and family.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

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

MARCH 20, 2025

Alex 00:48 And we’re delighted to welcome back Josh Briscoe, who’s a palliative care doc at the Durham VA Medical center in Duke and blogs at Notes from a Family Meeting. And it was very clear, and she could now no longer recognize her family members. And the family says, dad would never want to live like this.

IT 88

IT Patient-Centered Patients Medical 88

GeriPal

OCTOBER 27, 2022

So we have a list of various interventions like hospice referral, like more intensive treatment for blood pressure, more intensive treatment for diabetes, for dysglycemia, hyperglycemia, statins, bisphosphonates. So the time to benefit page is trying to make the mortality indexes link more closely to the time to benefit.

IT 95

IT Clinic Screening Patients 95

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. And that referral can be done in real time, a soft handoff. This is Eric Widera. Alex: This is Alex Smith.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

SEPTEMBER 19, 2024

And now when I think about the clinic at Duke, when we’re really running on all cylinders, we can get ourselves up to a five, six, seven week wait for a new palliative care referral. I don’t know if we captured where the hospice referral came from. So the problem of, hey, look at us, we promise we’ll be helpful.

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. Juliet: Because even in the ICU, they’ll often have multiple meetings just to try and help a family move along before they can make a decision. It’s part of our family mythology.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

MARCH 27, 2025

And so this is our way of supporting non English speaking families in advanced care planning. And I have a long interest in identifying family caregivers and supporting them in care delivery. And so this was really, in my view, a perfect window for reinforcing the role of family in primary care. Eric 02:32 Great, Alex.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

JUNE 6, 2024

And so clearly it matters how you bring up the topic, who brings up the topic, and probably the timing when this comes up for patients and families, just like we think about conversations about illness and prognostic understanding, I wish there was a good prevalent state data on how big this is of a problem in serious illness at large.

Illness 130

Illness IT Physicals Patients 130

GeriPal

JULY 20, 2023

She sought me out to come and tell me a story because about 10 years earlier, she and her family, their loved one was dying in a hospital in Florida and they tried to access palliative care and they couldn’t get the doctor to refer them to palliative care. I think you’re a loving family doing the best you can.”

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73