GeriPal

AUGUST 4, 2022

My take home from this is that while the most preferred explanation for deprescribing statins and sedative-hypnotics is one focused on the risk of side effects, we also need to individualize it to the patient and the medication that they are taking. Maybe that’s where the individualizing it, the person that’s front of me.

Specialization 104

Specialization Medical Patient-Centered Provider 104

GeriPal

JUNE 20, 2024

Alex 00:30 And we’re delighted to welcome Alison Huang, who’s a primary care doc and researcher and professor of medicine, urology, and epi-biostats at UCSF in the division of General Internal Medicine. Incontinence and avoiding issues can present in an older individual, in some cases, just like they do a younger person.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

OCTOBER 13, 2022

As you know, our population is aging at a rapid speed and older, adult older persons is no longer cared for only by a geriatrician or a primary care physician. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JUNE 12, 2025

But there are times that a primary care physician or an internal medicine physician may make the referral. Even if it’s a discussion that is involving the primary care physician, the geriatrician, the medical oncologist, the surgical oncologist. Eric 09:13 Do you ever get it from a hospice agency?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

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

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. It’s going to take efforts at the point of care with prescribing.

Management 122

Management IT Medical Patient-Centered 122

Doctor On Demand

APRIL 28, 2025

Most sore throats heal on their own, but severe cases may require urgent care. Learn more about which symptoms mean you should go to urgent care or the ER, as well as when to use telehealth or see a primary care doctor. However, there are “Red Flag” symptoms that require urgent evaluation and management.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

JUNE 19, 2025

Noelle Marie 01:24 I think it really speaks a lot to my own personal journey and I’m pretty sure a lot of trans and gender diverse individuals also resonate with and it really speaks about our transition, celebrating our authentic selves, how society views us and how we view ourselves when we stand in front of a mirror.

Individual 85

Individual Community IT Chronic Condition 85

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. And also I was in the HVMA primary care program.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JULY 21, 2022

That’s where it really gets to this individual risks and balances, individual situation. Eric: But before we jump into talking to your patients about driving retirement cessation, let’s talk about what is the role of the healthcare professional in this at all? Alex: Yeah. Is this our role? Emmy: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JANUARY 25, 2024

David: People with these illnesses suffer from persistent symptoms, poor quality of life, depression, anxiety, despite all the great things we do and all our colleagues in those specialties and in primary care and geriatrics. It sounds like this was a primary palliative care intervention. Eric: Oh, wow. Not the patients?

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

FEBRUARY 15, 2024

Katie: Well, if we just look at what we can do ourselves for our bodies, I mean strengthening, balance training, working on motor control, keeping ourselves fed so that we maintain our proper nutrients in our body so we can maintain an upright position, those are all key things an individual hopefully would be trying to do as best as they could.

Community 114

Community Transportation IT PCP 114

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. Maybe we’ll get to talking about that today. Jessie: Thank you.

Illness 136

Illness Patient-Centered Screening IT 136

BMJ

MAY 10, 2022

Family physicians and family health workers, considered reliable sources of vaccine information, have a unique position where individuals in rural and urban areas can access frequently, uninterruptedly, cheaply, and easily [2]. Two hundred seventy-six of the healthcare professionals were reached (response rate: 85.4%).

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination IT Individual Healthcare 87

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. Eric 15:57 2014.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

JUNE 5, 2025

Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve palliative care for individuals in nursing homes? Cognitive impairment. Kathleen 07:49 Yes.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

AUGUST 17, 2023

So what is the role of individuals like geriatricians in prescribing amyloid antibodies and caring for individuals who are receiving them? And I do think geriatricians need to as individuals make that decision, largely based on their comfort with the diagnostics and the specifics of the therapeutics.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

MARCH 28, 2024

Eric: And we’re going to get to results, but that’s why I also love that 2016 paper: I think it was the very first palliative care trial that ever looked at individuals getting curative therapy. It was the first randomized palliative care trial in hematology, is the way that I think of it. So what did this one show?

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. Eric: And what do we know about the outcomes of individuals getting these procedures, especially those with cognitive issues and dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 18, 2023

But there’s also studies that show they don’t because people end up being put back on the medications when they get back to their primary care or wherever they’re getting cared for out of the hospital within a certain period of time. Eric: Or another good example is like for individuals with dementia.

Medical 97

Medical IT Patients Clinic 97

GeriPal

AUGUST 31, 2023

He spent a long time as hospice medical director and he founded a national model of care that many of our listeners will be familiar with, AIM, which stands for the Advanced Illness Management program, which has influenced CMS policy. It’s all individual. They want to go back to before the illness, before the cancer.

Illness 128

Illness IT Diagnose Medical 128

GeriPal

OCTOBER 20, 2022

As you know, our population is aging at a rapid speed and older, adult older persons is no longer cared for only by a geriatrician or a primary care physician. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 20, 2025

The SAMHSA defines trauma as an event, series events or set of circumstances experienced by an individual as physically or emotionally harmful or life threatening, with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual. Well, being a pretty comprehensive definition.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

MARCH 3, 2022

And then when I did residency in internal medicine first, there was just a lot of focus on a lot of heroic management in the ICU that didn’t always appeal to me without thinking about what the morbidity might look like. I think we’re probably managing sicker patients on the floor. That’s just one hypothesis.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

OCTOBER 26, 2023

And so for pt, we’re generally focused on assistance with transfers, providing assistive devices to help people maintain independence with ambulation, doing stairs, leaving their homes, getting into the community, but really focusing on symptom management. It’s really hard to push the pause button and slow things down.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JUNE 22, 2023

So they can be referred by their primary care doctor or to us. You can choose comfort-focused care or you can choose to continue chemotherapy. Eric: So in some ways, this is kind of like the VA, where you don’t have to follow Medicare guidelines, but you can actually actively do concurrent care for these individuals.

Family 132

Family Families IT Community 132

GeriPal

MARCH 7, 2024

Whenever I take care of a patient, I see myself as a family practice doctor, but I’ve been a hospitalist, I’ve been a primary care doctor, and I’ve done palliative. It sets space between us and the individuals we’re trying to take care of. I often say that doulas are mirrors. Alex: Yeah.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

APRIL 10, 2025

It was like this patient is on hospice and call the case manager to figure out how the patient ended up here. So we did have a clinical decision support pop up that said, hey, this patient has serious illness, why don’t you go have a goals of care discussion? No difference in their primary outcome. No, no, no.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

APRIL 24, 2025

Eric 06:58 It could be CPR in an individual with metastatic cancer in the icu. And we were able to engage in a conversation about providing him the best care possible while he continues to engage in this therapy. That could include a robust home care plan to manage his symptoms. Laura 07:03 That could be a PULET.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

MARCH 10, 2022

It improves symptom management. That’s what nursing and nursing homes should be really, really good at: is providing nursing care that creates comfort. We got rid of all these psychotropic medications and this person … one individual had had a vascular dementia. Of intensively hand feeding?

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MAY 1, 2025

I mean, treatment is really best done in a chronic or continuity setting, whether it’s in a primary care setting or some other. But I think primary care clinicians, geriatricians, should be able to do at least the basic management and HIV care. In San Francisco, HIV care was more specialized in that.

Primary Care 94

Primary Care IT Provider Clinic 94

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

APRIL 20, 2023

What are the structural factors and individual factors that contribute to homelessness? ” On that grand rounds, you differentiated structural factors from … I forget what the word was, individual- Margot: Individual risk factors. Why do we say “over 50” is “older” for homeless persons, why not 65? Margot: After 50.

Mental Health 123

Mental Health IT Community Individual 123

GeriPal

SEPTEMBER 14, 2023

We had, since the late seventies, a home-based primary care program. And we would provide ongoing longitudinal care to them in the home, much like the Mount Sinai Visiting Doctors programs, and other programs like that. We relied on our clinical experience as geriatricians, that home-based primary care experience.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JULY 20, 2023

And the thought of a huge number of our patients who had really come to rely on being able to do their visits from home or from a place that was close to home and getting medications that they’ve really come to rely on for symptom management was just really kind of terrifying for us and for them. It may have come to a care manager.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73