GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Inspired by Dani Chammass paper in Annals of Internal Medicine titled, Wishing for a no show we talk about countertransference: start by asking yourself, Why am I having difficulty? Who follows the patient once the cancer goes into remission?

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

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IT Patient-Centered Patients Board-Certified 96

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. When I see a patient? Matthew, I get the lyrics.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. VA “gets” the importance of storytelling in medicine, without the need for reams of research to back it up. She was a heart failure patient. What’s in a story?

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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. This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient.

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IT Patient-Centered Healthcare Illness 105

GeriPal

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. .

Illness 109

Illness IT Family Families 109

GeriPal

MAY 18, 2023

There are some older adults in whom these are the correct drugs, either because of their particular clinical circumstances or because shared decision making and patient values and preferences. So we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Is this the right drug for this patient?”

Medical 97

Medical IT Patients Clinic 97

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. I went into emergency medicine to act.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

APRIL 28, 2022

Times , The BMJ , and Annals of Internal Medicine. . Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. Nathan: I do.

IT 145

IT Hospital Patients Illness 145

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. Shunichi Nakagawa’s Tweet that went viral on responding a patient request to drink ice water before death.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. And it was born when I was a medical resident at UCSF Internal Medicine. Because we all interface with it at the end of the day as patients.

IT 107

IT Community Patients Family 107

GeriPal

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. You know, we may have known people, we may have cared for people who were dying.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Think chemotherapy to imminently dying patients, or CPR. Think chemo.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

FEBRUARY 13, 2025

How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. Our consultation.

Consulting 63

Consulting Community Patient-Centered Family 63

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. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Rehabbed to Death.

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Nurse Practitioner Hospital Family Families 60

GeriPal

OCTOBER 3, 2024

Alex 00:08 UCSF’s Division of Palliative Medicine are looking to build on their research and clinical programs and are interviewing candidates for the associate chief of research position and for full time physician faculty to join them in the in-patient and out-patient settings. Lingsheng, welcome back to GeriPal.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. You didn’t have to walk many blocks down the street to a hospital or another facility where people were getting world class care. Naheed, welcome to the GeriPal Podcast.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MARCH 31, 2022

And maybe, just maybe, we convince that poetry skeptic Eric Widera that there is a place for poetry in medicine after all. Patient Poets: Illness from the Inside Out. I think it’s titled Patient Poets Illness. Marilyn: Patient Poets: Illness From Inside Out. Alex: Patient Poets: Illness From Inside Out.

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IT Patients Medical Illness 70

GeriPal

MAY 29, 2025

Particularly patients, families. Eric 05:30 And Andrew, I remember when I was a med student, I had a patient with a diffuse brain injury in the ICU on a ventilator. People are patients, families are wondering if their loved one is still in there. You know, I’ve been trying to think of metaphors for thinking about this.

Family 93

Family Families IT Patient-Centered 93

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” Widera and Smith have no relationships to disclose. What is ambivalence?

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

Who spends the most time with the patient in the infusion center? Mary Dwyer, who is a lawyer, and bioethicist and assistant professor at Case Western Reserve and University Hospitals. And so we had this run of consults and we walked out of each consult thinking and talking about how different each patient’s experience was.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

JULY 6, 2023

The idea was to create a robust community-based infrastructure that could help older adults succeed in their homes and communities, whether they were healthy, how to keep them healthy or they were at imminent risk of emergency room visits, hospitalizations, or nursing home placements. And that’s critical. Eric: Yeah.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 7, 2022

Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. And I was an internal medicine resident. Haider: And because it is so subjective and because we have these arbitrary rules around what the right patient with pain looks like, I think we really trap patients in a really difficult situation.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a pragmatic trial of advance care planning (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying commentary in JAMA Internal Medicine. I’m hearing dementia patients or patients with dementia.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Then it really wasn’t until I got into medicine, medical school and residency, that I discovered poetry per se, and a mentor commented, I think to a number of us on this podcast, Steve McKee introduced me to poetry.

Patient-Centered 93

Patient-Centered IT Community Illness 93

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.” Care Ecosystem.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

DECEMBER 12, 2024

Surrogates often either dont know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients. Alex 01:29 And we’re delighted to welcome Teva Brender, who’s a third year resident in internal medicine at UCSF. Can we do better?

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

GeriPal

JUNE 2, 2022

We’ve lived through lockdowns, toilet paper shortages, mask mandates, hospital surges where ICU’s overflowed, a million COVID deaths, prolonged school closures, development and roll out of novel vaccines, an explosion of social isolation and loneliness, and the invention of the “zoom meeting.” . But hospitalizations are low.

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Vaccination IT Hospital Management 100