GeriPal

NOVEMBER 14, 2024

What are ways we should screen for falls? This is Sarah Berry, who is at the Hebrew Senior Life and Beth Israel Deaconess Medical center and Harvard Medical School. People don’t ask about it, they don’t screen about it. How do you screen or assess for risk for falls? What about Vitamin D and falls???

IT 124

IT Screening Patient-Centered Community 124

GeriPal

FEBRUARY 22, 2024

Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). We saw that around 60% of people were screening positive for depression in the last month before death. Or is it that I’m just not screening? That’s a lot.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. Alex 01:23 And we’re delighted to welcome DorAnne Donesky, who is a palliative care nurse practitioner at Queen of the Valley Medical center in Napa and professor emeritus at the UCSF School of Nursing.

Screening 119

Screening IT Family Families 119

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. Stay tuned for a GeriPal podcast with the authors of the other study next week. David: Thank you.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

FEBRUARY 15, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Community 114

Community Transportation IT PCP 114

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Is this our role?

IT 102

IT Family Families Diagnosis 102

GeriPal

JANUARY 18, 2024

After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise. So, we are not screening for substance use in cancer care, so we don’t get good estimates among people with cancer, which is really how we would prefer to ask the question. Katie: Yeah.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

SEPTEMBER 7, 2023

Because a lot of my colleagues, who are like transplant coordinators for example, are asking, “Can you help us better screened for which older adults would be fit enough to go for transplant? There’s really no added extra resource or time that the coordinators really need to put to doing the screening, themselves.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

APRIL 3, 2025

We covered: The first parody song I wrote, for AGS 2018 in Orlando , about this article by Nancy Schoenborn on how to discuss stopping cancer screening. This was 2018 in AGS Orlando, and they did a song about when to stop screening for cancer for colon cancer. How to talk to patients about screening colonoscopies. Ken 10:29 Yes.

IT 64

IT Hospital Screening Patients 64

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. We’re going to be talking about the American Geriatric Society position statement on making medical treatment decisions.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. Think of the 10 years it takes to benefit from colon or breast cancer screening, which is designed to detect slow growing cancers.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

MAY 22, 2025

You can hear Tyler and I having a great time singing together and sharing stories around his podcast My Medical Mixtape. And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ? And so this is a shout out to our inpatient palliative team at Dell Medical School.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JULY 28, 2022

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. I had it on my screen. And so I went into medical school wanting to cure cancer. Welcome to the GeriPal podcast, Jennifer. Jennifer: Thanks. Jennifer: Yeah.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. So, Alex, imagine you’re a seriously-ill hospitalized patient and I’m your doctor, unluckily for you.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. What made this trial, I would say, unique, is that you have a palliative care physician and nurse following people with medication tapering in order to be dosed. So medication adjustments. James, welcome to the GeriPal Podcast. James 00:32 Good afternoon. Im b leary eyed.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

APRIL 28, 2022

I’m going to share my screen and we can talk about that. And I’m just going to explain it to our listeners, what I’m seeing on my screen. Nathan: I have drawn for my entire life, but I gave up cartoons because I thought I had to during medical school and residency. Eric: And this one just came out.

IT 145

IT Hospital Patients Illness 145

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. ” BJ: Well, I fall back on using physiology in the sort of medical sense. laughter] Eric: And part of that is this idea of, in hospice, sometimes we just try to medicate suffering away. We medicate that away. Pain Manag Nurs. 2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

APRIL 13, 2023

Julianne: It’s interesting because I think I read somewhere that a finding in science often takes about, on average, 17 years to make it into medical practice. We’ll talk about is it in medical practice yet? She tried to extend conversations beyond what was medically, I think, necessary for the encounter.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

APRIL 6, 2023

A friend of GeriPal, and prior guest, Guy Micco commented today that we need an RCT for chaplaincy is like the idea that the humanities need to justify their value in medical training: “It’s like being told to measure the taste of orange juice with a ruler.” It is a screening? These studies are important. What’s involved in this?

IT 99

IT Patient-Centered Family Families 99

GeriPal

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. Like, does that indirect? Is that also a trauma? Mariah 23:02 Right.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

JUNE 5, 2025

And assisted living doesn’t offer the same level of medical supportive services as nursing homes. And so they’re in there for a very short time, couple weeks, get a little bit stronger and transition home after a hospitalization. You know, they’re trying to give medication to a number of patients.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

DECEMBER 5, 2024

Alex 00:23 All right, first, we’re welcoming back Ricky Le it er, who’s a palliative care doc at Dana Farber Cancer Institute in Brigham Women’s Hospital and Harvard Medical School and is co-founder of the Palliative Story Exchange. I’ve been running a medical storytelling program called the Nocturnus.

IT 107

IT Community Patients Family 107

GeriPal

OCTOBER 27, 2022

So if you can think about certain decisions like continuing to screen for certain cancers like colon cancer or breast cancer, or how strict you should control diabetes or blood pressures. We know that a lot of times with cancer screening, you don’t actually get benefits right away and it can cause potential harms right away.

IT 95

IT Clinic Screening Patients 95

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. Ruth: Thank you.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

FEBRUARY 13, 2025

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. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. By then they usually were out of the hospital actually. Eric 10:25 And who was included?

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

AUGUST 24, 2023

Summary Transcript Summary I hear the word dignity used a lot in the medical setting, but I’m never sure what people mean when they use it. Medical Assistance in Dying and Palliative Care: Shared Trajectories Transcript Eric: Welcome to the GeriPal Podcast. And we published in the Journal of the American Medical Association.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MAY 29, 2025

From perhaps the most sensitive instrument that we can get the family members report, while at the same time trying to sort of screen out potential false positives that are due to false hope or something like that. So what I remember is, is multiple hospitals and they did EEG during CPR during a cardiac arrest.

Family 93

Family Families IT Patient-Centered 93

GeriPal

DECEMBER 7, 2023

And so we do see hospital admissions for heat exposure and certainly cardiovascular and respiratory problems related to air pollution with climate change and also cognitive problems. And it is going to affect, if it hasn’t already, our food quality, the food that’s available, our medications. Ruth: Right. Ruth: Yeah.

Healthcare 129

Healthcare IT Education Hospital 129

GeriPal

APRIL 18, 2024

Then, it was like, well, it does as well as, and now, better than humans passing the medical boards, passing the law boards, doing great on the SAT, all that stuff. At the Mayo clinic, for example, they’ve got a very robust hospital at home program. Bob: Yeah, but you can imagine- Alex: I wish, but I worry I will not. Bob: Yeah.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

JULY 13, 2023

[laughter] Bob: That’s what happens when junior faculty get invited on the podcast [laughter] Eric: So we’re going to be talking about the article that just came out in JAMA on a priming intervention for goals of care conversations in hospitalized patients with serious illness. Three hospitals all within the UW medicine system.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

GeriPal

MAY 1, 2025

And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. And I graduated from medical school in the early 80s. Meredith, welcome to the GeriPal Podcast. Meredith 00:48 Thank you, Alex and Eric. Have been now a care provider for people with HIV for over 40 years.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

FEBRUARY 24, 2022

Alex: And we’re delighted to welcome back, a frequent guest to our podcast, Rachelle Bernacki, who’s a palliative care physician and geriatrician at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital. We see our patients and our families throughout the illness trajectory into the hospital.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

APRIL 21, 2022

We talk not only about reading poetry, but also writing poetry, and using poetry in medical education as a healing modality. In medical school, I worked with Mike on the comprehensive care team long before there was Jennifer Temple’s randomized trial of outpatient palliative care for cancer. Mike and I go actually way back.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. We would admit them to the hospital. Who doesn’t want to leave the hospital?

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

DECEMBER 21, 2023

The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. Malaz: … to restrain them in the hospital. You come over to the clinic, you go to the hospital, you provide service, and the insurance and you negotiate how much you’re going to get paid.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

JANUARY 5, 2023

No matter what your position on medical aid in dying (I’m ambivalent) or abortion (I’m pro-choice), this is a bioethics podcast, and I hope that we can all agree that the ethical issues at stake deserve a critical re-think. Today, medical aid in dying is legal in some 10 states, and illegal in others. . Summary Transcript Summary.

Provider 19

Provider Medical Hospital IT 19

GeriPal

JULY 14, 2022

Imagine that you are the medical director of a large (>150 bed) nursing home. This was the opening paragraph that I wrote in March of 2020 when introducing a podcast we did with Dr. Jim Wright , the medical director at Canterbury Rehabilitation and Healthcare Center in suburban Richmond. Summary Transcript Summary.

Nurse Practitioner 136

Nurse Practitioner Patient-Centered Vaccination Emergency Room 136