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GeriPal

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GeriPal

Alex Smith, Eric Widera

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A geriatrics and palliative care podcast for every health care professional. We invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. You'll laugh, learn and maybe sing along. Hosted by Eric Widera and Alex Smith.
 
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In today’s podcast we talk with Dr. Rajagopal (goes by “Raj”), one of the pioneers of palliative care in India. Raj is an anesthesiologist turned palliative care doctor. He is also author of the book, “Walk with the Weary: Lessons in Humanity in Health Care,” and was featured in this Atlantic article. Raj is the founder of Pallium, an organization …
 
Think about the last time you attended a talk on communication skills or goals of care discussions. Was there any mention about the impact that hearing loss has in communication or what we should do about it in clinical practice? I’m guessing not. Now square that with the fact that age-related hearing loss affects about 2/3rd of adults over age 70 …
 
Comics. Cartoons. Graphic Novels. Graphic Medicine. I’m not sure what to title this podcast but I’ve been looking forward to it for some time. Heck, I’m not even sure to call it a podcast, as I think to get the most out of it you should watch it on YouTube. Why, because today we have Nathan Gray joining us. Nathan is a Palliative Care doctor and an…
 
In celebration of National Poetry Month, we are delighted to share with you the second podcast in our series on poetry and medicine. In the first podcast, we talked with Guy Micco and Marilyn MacEntyre about poetry and aging. In this second part in our series, we welcome Mike Rabow and Redwing Keyssar to talk about palliative care and poetry. As wi…
 
Buprenorphine. It’s been around for a long time but is acting like the hot new kid in town. Just look at this year’s AAHPM meeting, where it felt like every other session was talking about how hot buprenorphine is right now. But does this drug really live up to the hype? On today’s podcast we talk with three experts on buprenorphine on why, when, a…
 
In her essay “Why Read a Poem in a Time Like This?”, Marilyn McEntyre writes: All of us need it. We need it because good poems do something prose can’t do. They invite and enable us to notice the precarious fissures in what we think is solid ground. They direct us toward the light at the edge of things — the horizon, the fragment of dream before da…
 
One of my favorite Piece of My Mind essays in JAMA is by Rebecca Sudore, titled, “Can We Agree to Disagree?” And today our guests agree to disagree. And yet, and yet… They also agree across a whole range of issues, some of which surprised us. This is the latest in our series of podcasts on concerns about, and potential of advance care planning. If …
 
If you develop dementia, odds are you will spend the last months to years of your life in a nursing home or assisted living facility. While we like to think about how our goals and preferences will influence what that life looks like, including whether you will get potentially burdensome interventions, your fate is probably influenced more by facto…
 
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. This idea that for critically il…
 
There is a lively debate going on in academic circles about the value of Advance Care Planning (ACP). It’s not a new debate but has gathered steam at least in palliative care circles since Sean Morrisons published a JPM article titled “Advance Directives/Care Planning: Clear, Simple, and Wrong.” Since then there has been a lot of back and forth, wi…
 
My mom is an Asian woman in her 70s with osteoporosis. She tried an oral bisphosphonate and had horrible esophagitis. She said never again, though she eventually tried an IV bisphosphonate. She had terrible flu-like symptoms. She said never again. But based on reports that symptoms are worse the first time, she tried the IV again the next year and …
 
This week many of our listeners will gather for the annual American Academy of Hospice and Palliative Medicine (AAHPM) & Hospice and Palliative Nursing Association (HPNA) annual meeting. While the majority of this meeting is focused on subspecialty care in the US, the majority of individuals who are in need of palliative care live in low and middle…
 
In prior podcasts we talked about racism and COVID, lack of diversity in the palliative care workforce, racial and ethnic differences in end of life care, and implicit bias in geriatrics and palliative care. Today our focus is on structural, institutional, and interpersonal racism, and how these different but related constructs negatively impact th…
 
Patients with end stage liver disease and decompensated cirrhosis have an average life expectancy of 2 years without transplant. Outcomes are worse among those who are frail. Symptoms are common, including pain, ascites, encephalopathy, and pruritus. Patients with end stage liver disease are often some of the most disadvantaged patients we care for…
 
More Health Policy this week! Today, we discuss “SNPs” but this is not a podcast about haircuts during the pandemic. We take a deeper dive into the world of Medicare Advantage and what it means for vulnerable patients facing serious illness and those at the end of life. We are joined by UCSF geriatrics fellow Alex Kazberouk to talk to Dr. Claire An…
 
Investor money and venture capital funding is pouring into Medicare Advantage (MA) plans. Enrollment in MA plans has more than doubled from 12 million members in 2011 to 26 million in 2021. What does this mean for us and our patients? Do these plans deliver better care for vulnerable older adults? Or are they a money making machine driving up healt…
 
Three months ago we did a podcast with Randy Curits about his recent diagnosis of ALS in March and what it was like for someone who studies and cares for people living with serious illness, to now be someone who is living with serious illness. It was one of our favorite podcasts we’ve done, but also got us to think “wait, how come we’ve never done …
 
It’s GeriPal’s 200th episode. Yup, we started the podcast in 2016 and over the years we have grown from basically podcasting for Alex’s mom to now getting over 25,000 plays per month. So to celebrate our 200th, and given that the last two years kinda sucked in a lot of ways, we are going to pivot to appreciative inquiry. We have invited leaders in …
 
Geriatric Oncology has arrived. Yes, Louise Walter has been leading the fight to improve cancer screening in older adults for years. But when it came to geriatricizing the way we assess and treat older adults with cancer, the evidence was thin. In our prior podcast with Supriya Mohile and William Dale on geriatric assessment in oncology, we couldn’…
 
Geriatric anesthesia is a thing. The average age of people getting surgery is increasing. Anesthesiologists and surgeons feel that with new techniques and approaches they can perform surgery on patients at ever older ages, patients who they previously would have excluded from surgery. One of the key advances in geriatric anesthesia is the use of sp…
 
The great resignation is upon us. One in five health-care workers has left their job since the pandemic started. Geriatrics and palliative care are not immune to this, nor are we immune to the burnout that is associated with providers leaving their jobs. In today’s podcast, we talk with Janet Bull and Arif Kamal about what we can do to address burn…
 
I don’t consider myself spiritual. For some in palliative care, this would be considered heresy as we are told “everyone is spiritual.” But, hey, I’m not. So there. However, despite not being spiritual, I do believe that spiritual care is fundamental to the care I give patients and families. I also recognize it is the one palliative care domain I a…
 
Though “breath” is in the title of Wes Ely’s book (and his song choice by the Police), relationships are its beating heart. The book operates on two levels. On one level, Wes Ely’s book is an autobiography of a critical care doctor’s horror and shame at discovering that his ICU practice of heavily sedating patients for days on end was leading to li…
 
Anyone who cares for individuals with serious illness must live in a messy space where tough conversations about treatment decisions are common and complicated. On today’s podcast we talk with James Tulsky about living in this messy space of medical decision making and the challenges that come with communication around advanced treatment decisions.…
 
“The secret sauce of the Transitions, Referral and Coordination (TRAC) team was including a lawyer.” This is brilliant and will ring true to those of us who care for complex older adults who end up in the hospital for long, long, long admissions. On today’s podcast we talk with Kenny Lam, Jessica Eng, Sarah Hooper, and Anne Fabiny about their succe…
 
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