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

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

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 22, 2025

We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, todays guests love music at least as much if not more than me, and they each make a strong case for music as medicine. This is not highly scripted orchestral music, people, its Jazz.

IT 96

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

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

MAY 18, 2023

So the intention of the AGS Beers Criteria is to provide information primarily to clinicians, although to other audience as well, but medications that we consider to be potentially inappropriate in older adults. So we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Mike: Thank you.

Medical 97

Medical IT Patients Clinic 97

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

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 IT Hospital Patients 77

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? Where was it?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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 Illness 96

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

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

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 6, 2025

We discuss the principles of harm reduction, social determinants of health, and trauma informed care. By the time he got into us, the tumor grew, he had experienced, he was experiencing significant pain and so trauma, informed care and building a relationship with him was such a big part of the care. On bias and trauma as you.

Healthcare 100

Healthcare IT Community Illness 100

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? And then we incorporated that information into the consultation process. Later on, of course, we added health professionals to, you know, give us more information.

Consulting 63

Consulting Community Patient-Centered Family 63

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

MARCH 10, 2022

Archives of Internal Medicine 2010. One of them is Karen Steinhauser’s Annals of Internal Medicine paper on, In Search of a Good Death. ” Ruth: Yes, you could say that if somebody had all the information they needed and chose a form of treatment, then yes, that’s a difference. Rehabbed to Death.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MARCH 20, 2025

Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self?

IT 87

IT Patient-Centered Patients Medical 87

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? MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Eric: So not from the patient perspective or family, but from the provider perspective? Doing home care? Hospice visits?

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

AUGUST 1, 2024

Anna Pleet is an internal medicine resident at Allegheny Health Network who has a collection of amazing YouTube videos on aging and the Mediterranean diet. Elizabeth Eckstrom is a geriatrician, professor of medicine at OHSU, and author of a new book, the Gift of Aging. Widera and Smith have no relationships to disclose.

IT 116

IT Diabetes Chronic Disease Patient-Centered 116

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. MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Why do this?

Family 106

Family Families Patient-Centered IT 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 Patient-Centered 79

GeriPal

JULY 7, 2022

And I was an internal medicine resident. Every time you experience pain, it is informed by so many different things. Let’s say you get stuck in a trap and you might scream, is to inform other people that there might be a threat or to inform other people that you may not be able to do a certain task because you are hurt.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

JULY 6, 2023

I’ve been on a quest to build those services and support so that people can make true, informed decisions for themselves and their families. We’re selling objectivity, information, independence and choice. We just kind of start to amass these handouts and I would give them to the patient. Is it the patient?

Community 89

Community Nurse Practitioner Provider IT 89

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

NIH study about long COVID published the day before in Annals of Internal Medicine. But we have very little information, almost no information. So you plan on your geriatrician, older patients, getting it every year. Monica: And the patient said, “I don’t like my doctor wearing masks.”

Vaccination 100

Vaccination IT Hospital Management 100