GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? Alex is a triple-boarded (palliative care, internal medicine, and psychiatry) assistant professor of medicine at Stanford. Widera and Smith have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. Great to be back.

Primary Care 95

Primary Care Diagnosis Screening IT 95

Mesa Family Physician

MARCH 13, 2025

The Hidden Benefits of Regular Check-ups You Might Be Missing Many residents of Mesa and the surrounding Arizona communities don’t realize that preventive care goes far beyond just “checking the box” for your annual physical. We work with most major insurance plans and offer transparent pricing options for self-pay patients.

Family Physician 100

Family Physician Preventive Care Preventative Care Family 100

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.

Illness 136

Illness Patient-Centered Screening IT 136

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

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

JULY 3, 2025

I started out being interested in prognostic communication, and I work now in a cancer center, in the cancer center at mgh, where the early palliative care trials happened. And we’re still early palliative care trials are on. To learn more about CME for other GeriPal episodes, click here. Are you a hammer? Like, we just.

Patient-Centered 55

Patient-Centered Illness Clinic IT 55

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. Initially, it was just because there weren’t really answers for my patients. Emmy: So that older person or person with maybe terminal illness or developing impairments, it might make sense for them to just keep driving because they don’t have a good replacement.

IT 102

IT Family Families Diagnosis 102

GeriPal

JUNE 15, 2023

Alex: And joining us via Zoom, we have Charlotta Lindvall, who is a palliative care physician researcher who studies the intersection of natural language processing and communication data at Dana Farber Cancer Institute, where she also works in clinical informatics. Alex: Yeah, that means you could see more patients, right. Eric: Yeah.

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IT Patient-Centered Patients Healthcare 99

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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. We delighted to be joined by Brian Block, pulmonary/critical care faculty at UCSF and frequent guest host on GeriPal…and also nephew to Susan. Transcript.

Illness 109

Illness IT Family Families 109

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. . Completion of advance directives and billing codes for advance care planning as quality metrics.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

JUNE 9, 2022

When should people get palliative care? We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s trained in pulmonary critical care and palliative care. She’s a palliative care researcher. I think that palliative care in the ICU is an absolute important area.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

APRIL 4, 2024

The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients. What words to use? Is the POLST useful? Under what circumstances? Should we abandon the term, “comfort measures?”

Family 112

Family Families Patient-Centered IT 112

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 I feel like a lot of this is really, you know, moving away from another podcast we did is industrialization of healthcare and really focusing on the individual that’s in front of you. We are not a Monolith.

Individual 85

Individual Community IT Chronic Condition 85

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. Hillary: I certainly agree lots to think about. Hillary: So those all differ.

Community 95

Community IT Patient-Centered Primary Care 95

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.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MARCH 28, 2024

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. And that’s it. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

SEPTEMBER 5, 2024

And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics. The patient case. Louise, welcome back to GeriPal. Louise 00:26 Thanks for having me.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

JUNE 5, 2025

Summary Transcript CME Summary The need for better palliative care in nursing homes is significant. nursing homes grapple with serious illnesses, and roughly half experience dementia. Like, do they have palliative care needs? What were you seeing when you saw that need for palliative care? million adults residing in U.S.

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Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. We do conversations on goals of care and advanced care planning as well. The last thing I’ll say is I actually saw his very last performance.

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Provider Illness IT Healthcare 117

GeriPal

JUNE 22, 2023

Healthcare staff were afraid of patients with HIV because there wasn’t clarity on how it was transmitted. So if healthcare staff are concerned, custodial staff are concerned, the other incarcerated people. But now we have older people dying of older people illnesses. Eric: Mm-hmm. That’s one.

Family 132

Family Families IT Community 132

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? I cant do the primary thing Ive been trained to do: ABC, ABC, ABCs. Alex 02:53 Did the patient survive the CPR? They got feedback.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. link] Kensington Hospice & ‘Radical Love’ Equity-Oriented Hospice Palliative Care Naheed Dosani also serves as the Medical Director of Kensington Hospice, Torontos largest hospice. People with.

Healthcare 100

Healthcare IT Community Illness 100

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. Which may not be necessarily traumatizing.

IT 66

IT Patient-Centered Screening Patients 66

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. Because we all interface with it at the end of the day as patients. Today’s podcast is both similar and different. Is that a theme that you’re working on?

IT 107

IT Community Patients Family 107

GeriPal

JUNE 6, 2024

Summary Transcript Summary As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. But one issue we’re not as good at discussing with our patients is sexual health. Clearly this issue is important to patients. So we got a lot to cover on sexuality, sexual health, and serious illness.

Illness 130

Illness IT Physicals Patients 130

BMJ

AUGUST 20, 2021

By John Scott Frazer, Glenn Ross Frazer Reference : Frazer JS , Frazer GR, Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model, Family Medicine and Community Health 2021; 9: e001143.

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Primary Care Supply Chain General Practitioner Vaccination 40

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. Jennifer, welcome to the GeriPal Podcast. Sydney 00:41 Thank you.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

MAY 1, 2025

And so the patients who had been admitted there to die, essentially most, if not all, got better and HIV became much more of a chronic condition. It is kind of weird that my first publication was in jama, part of the Care of the Aging Patient series. And I think patients too, don’t always people. And that was.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

JULY 7, 2022

So Eric Cassell, for folks who don’t know, was a primary care physician. But really was a seminal pioneering figure in the field of bioethics, palliative care, et cetera. One of the patients I spoke to really said this quite well. One of the definitions I liked a lot was the late Eric Cassell’s definition-.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. 2020 Hospital at Home-Plus: A Platform of Facility-Based Care. We had, since the late seventies, a home-based primary care program. Annals of Int Med.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 20, 2023

Clinicians could care for patients across state lines, could prescribe opioids without in person visits, could bill at higher rates for telemedicine than previous to the pandemic. Many patients benefited, not only those isolating due to covid, but also patients in rural areas, patients who are homebound, and many others.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73