GeriPal

OCTOBER 13, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MAY 19, 2022

Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. And really, the best that had ever been looked at, especially in our population and sort of a cancer serious illness population. Landmark study. Is that right?

IT 139

IT Patients Individual Relationship 139

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. We’re going to be talking about new research in psilocybin in serious illness. Vincent’s Hospital in Melbourne, Australia. This is Eric Widera.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

JUNE 12, 2025

I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. So we need to have a discussion upfront about how we’re managing the patient’s pain. There really was very little. And was that okay?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

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 Clinic 136

GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Management of chronic pain in the elderly: focus on transdermal buprenorphine. Transcript. Right, Katie?

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. We also discuss (without trying to get too wonky!) Let it be (hint hint).

Management 116

Management Patient-Centered Patients IT 116

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. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though. Liz: Right.

Hospital 125

Hospital IT Patient-Centered Patients 125

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

The Clinical Problem Solvers

MAY 2, 2022

Dr. Valtis is a 4th year Med-Peds Resident at Brigham & Women’s Hospital and Boston Children’s Hospital, and his research focuses on race and the utilization of security responses in the inpatient hospital setting. Yannis Valtis, Ebi Okah, and Carine Davila, about research in their respective fields.

Healthcare 52

Healthcare Utilities Hospital Internal Medicine 52

GeriPal

SEPTEMBER 22, 2022

Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. One bump is just the classic pitfalls we often talk about in serious illness communication: being very jargony, very information focused, and just providing information. It flows very well. Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? For more details, please click here. (AP AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

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

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers. Transcript.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today. Eric 05:03 Nice.

IT 132

IT Illness Family Families 132

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Bennett, C.R., Schilling, L., Doorenbos, A. PMID: 26701962.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Eric 00:51 So we’re gonna be talking about caring for people with serious illness and substance abuse. Who has a song request for Alex before we talk about substance use disorder and serious illness?

Patients 72

Patients Clinic Patient-Centered Illness 72

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. Many were community hospitals. Participants were critically ill and intubated. What is sludge? The prognosis nudge did nothing.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

DECEMBER 15, 2022

So during the dissertation, that was a method for my PhD research and that’s related to… I was learning about African American elders experiences of psych-social-spiritual healing and serious illness. Been in the hospital four times, vented, been told the story to her family, she won’t live.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. His story, which he shares on todays podcast, is remarkable.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. 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. Eric: Well, Terri and Emmy, thank you for joining on this podcast.

IT 102

IT Family Families Diagnosis 102

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended? Yael 30:29 Exactly.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. So less than six months to live.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

JANUARY 30, 2025

And I would say we weren’t doing training on symptom management, for example. We really spent a lot of time helping the clinicians see that a patient’s illness, understanding and prognostic awareness was just as important as their pain scale, their pain score. Lynn 15:55 Well, it’s a good. And well skilled.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. As always, I’m your host, Brad Sobolewski, and this episode focuses on the management of children with metabolic disorders who present to the emergency department. Inborn Errors of Metabolism.

Consulting 59

Consulting Individual Family Families 59

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’m embedded in the ICU in one of our smaller hospitals. I see them both inpatient and outpatient.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. by Kearney. Lovely to be here.

IT 104

IT Patient-Centered Family Families 104

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? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable.

IT 83

IT Family Families Illness 83

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. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

AUGUST 25, 2022

And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices. As a nurse case manager in hospice, half of my patients had dementia. There’s also been some differences in things like staffing.

Family 106

Family Families IT Patients 106

GeriPal

MARCH 24, 2023

I think some individuals thought there was cherry-picking of stories that made it seem like hospice is this bad thing, that it’s taking advantage of vulnerable individuals and it didn’t talk enough about the good things that hospice does. How many patients is my hospice nurse case manager responsible for on any given day?

IT 113

IT Provider Patients Family 113

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. We are joined by guest-host Tom McNally, a rehab and pediatric palliative care doc at UCSF. They shared their experiences.

Community 115

Community IT Relationship Healthcare 115