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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.
 
This podcast is grounded in Palliative Care concepts. We explore topics and tools to create an amazing day amidst dying. My own insights and others' that have something to say about dying well in this modern age, healing symptoms and supporting the people who are supporting our dying loved ones. May we bring peace and comfort to ourselves and to our communities.
 
HPM TALK is the podcast of NHPCO's MyNHPCO Physician and Advanced Practice Provider Community. This podcast connects you with leaders in the field to discuss issues pertinent to our practice and to bring you the voices of other physicians and advanced practice providers who will share their experiences in the field. A rotating team of hosts will address topics of interest to the hospice medical director, hospice physician, advanced practice provider in hospice and palliative care and the pal ...
 
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How long does it take to see a benefit of statin therapy for primary prevention of cardiovascular events in adults aged 50 to 75 years? That's the question we try to answer with our two guests today, Drs Lindsey Yourman and Sei Lee, the lead and senior author of a JAMA IM study that tried to answer this question. In this podcast Drs. Yourman and Le…
 
An age friendly health system is one in which everyone, from the doctors to the nurses to the people cleaning the rooms are aware of the unique needs of older adults. These needs are categorized around the 4 M’s - Medication, Mentation, Mobility, and What Matters Most. But we cannot achieve the ideal of an age friendly health system without, well, …
 
The Emergency Department (ED) is a hard place to have serious illness discussions, whether it be goals of care or code status discussions, or whether or not to consider intubation for a seriously ill patient. Emergency physicians often don't have the time for in-depth discussions, nor have been trained on how to do so. There often is limited inform…
 
In this week's podcast we talk with Kieran Quinn, author of a systematic review and meta-analysis of palliative care for non-cancer illness, published in JAMA. We also talk with Krista Harrison, first author of an accompanying editorial. JAMA editors cut out some of my favorite parts of Krista's editorial, possibly because they were more like a blo…
 
There are a lot of large numbers that involve heart failure, starting with the sheer number of patients diagnosed (6.5 million and counting), to the cost of their care (~$70 billion by 2030), to the amount of money invested by the NIH into research ($1 billion annually). But the smaller numbers deserve attention too - 50% of patients die within 5 y…
 
On todays podcast, we have Lauren Moo, a cognitive behavioral neurologist who has been doing video visits well before the COVID-19 pandemic to decrease the need for travel and to decrease the agitation in older adults with dementia that commonly occur when a clinic visits disrupts the usual routine. Now with COVID among us, Lauren talks to us about…
 
Last month we published a podcast with Sean Morrison that garnered a great deal of attention, in which Sean Morrison argued that Advance Care Planning is an idea that is “clear, simple, and wrong.” This week, we have a fresh updated counterpoint from Rebecca Sudore and Ryan McMahan. These two published a paper this week in the Journal of the Americ…
 
In 1968 a committee at Harvard Medical School met to lay down the groundwork for a new definition of death, one that was no longer confined to the irreversible cessation of cardiopulmonary function but a new concept based on neurological criteria. Over the next 50 years, the debate over the concept of brain death has never really gone away. Rather …
 
We discuss cardiogenic shock and decision making in the case of a young female presenting to the ER. We have a panel of cardiologists guide the discussion. Drs Rene Alvarez, Daniel Sims and Alec Vishnevski discuss the case presented by cardiology fellow Rachna Kataria, MD. Thanks for listening. Please like, subscribe and give us a rating.…
 
Chris Callahan (of Indiana University) and Lee Jennings (University of Oklahoma) have some righteous anger. Why do we have comprehensive cancer care centers and not comprehensive dementia care centers? We have a body of evidence dating back 30 years to support people with dementia and their caregivers with Comprehensive Dementia Care. Lee Jennings …
 
Every year, about a third of older adults fall. About one in five of those falls result in moderate to severe injury. What can we do to help not only prevent those falls but also the complications of them? On todays podcast, we talk to Tom Gill, one of the authors of the recent Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE)…
 
No dear listeners and readers, that is not a typo. Eric Widera is indeed our guest today to discuss his first author publication in the New England Journal of Medicine, Family Meetings on Behalf of Patients with Serious Illness. Our other guests include other authors James Frank, Wendy Anderson, Lekshmi Santhosh, me and actress and frequent GeriPal…
 
COVID-19 has created a perfect storm in nursing homes. As noted in a recent Journal of the American Geriatrics Society (JAGS) article by Joe Ouslander and David Grabowski, the storm is created by the confluence risks, including a vulnerable population that develop atypical presentations of COVID-19, staffing shortages due to viral infection, inadeq…
 
Sean Morrison dropped a bomb. It's a perspective I've heard before from outside of palliative care, most clearly by bioethicists Angie Fagerlin and Carl Schnieder in their landmark article Enough: The Failure of the Living Will. But Sean Morrison, Director of the National Palliative Care Research Center and Chair of the Department of Geriatrics and…
 
We discuss the various aspects of cardiogenic shock including definition, heterogeneity, classification and management with an internationally renowned expert in the field Dr Navin Kapur. Dr Kapur is the Director of the Acute Mechanical Circulatory Support Program at Tufts University School of Medicine, Boston, MA. Listen, like, subscribe, and give…
 
We discuss several aspects of cardio-oncology including screening protocols, specific chemotherapy related cardiotoxicities and management of cardiovascular disease among cancer patients and cancer survivors. Dr Sherry-Ann Brown is the director of Cardio-Oncology at the Medical College of Wisconsin, Milwaukee, WI. Listen, like, subscribe, and give …
 
In this week's GeriPal podcast we talk with Louise Aronson, author of the Pulitzer prize finalist Elderhood (https://www.amazon.com/Elderhood-Redefining-Transforming-Medicine-Reimagining/dp/1620405466). Louise has been one of the (sadly) few voices beating a loud and urgent drum in the medical and lay press about the insidious ageism taking place i…
 
We discuss several aspects of cardiac arrhythmias and their management among cancer patients and cancer survivors with Drs Fradley and Guha. Dr Fradley is an electrophysiologist and Dr Guha is a non-invasive cardiologist, both with tremendous expertise in cardio-oncology. Dr Fradley is the Medical Director of Cardio-Oncology at University of Pennsy…
 
We discuss some radiation physics, role for ionizing radiation in treating cancer & related cardiac damage with Dr Brett Lewis MD PhD. Dr. Lewis has interest & expertise in treating several thoracic malignancies & practices at Hackensack Meridian Health, NJ. Listen, like, subscribe, and give us a high rating.…
 
Despite being in the field over 15 years, I've never felt so far outside my comfort zone as as palliative care provider as I have felt in the last four months. A worldwide pandemic of a novel virus had me questioning how I communicate prognostic information when uncertainty was one of the few things I was certain about. It also pushed me to have th…
 
If you looked at the academic literature, you would think that elder abuse and neglect, collectively called elder mistreatment, did not exist before the 1990s. Of course that's not true at all, it was hidden, covered, and not a major subject of research. Several pioneers have placed elder mistreatment firmly on the map, including XinQi Dong, Mark L…
 
We discuss several classes of cancer therapies including chemotherapy, immunotherapy, CAR T-Cell therapies and related cardiovascular toxicity from the perspective of a board certified oncologist Dr Kaushal Parikh, MD. Dr Parikh specializes in thoracic oncology and practices at Hackensack Meridian Health, NJ. Listen, Like, Subscribe, and give us a …
 
This was a remarkable podcast. Eric and I were blown away by the eloquence of our guests, who were able to speak to this moment in which our country is hurting in so many ways. Today's topic is the impact of COVID19 on minority communities, but we start with a check in about George Floyd's murder and subsequent protests across the country. Our gues…
 
The question of who should get limited supplies of drugs that treat COVID-19 is not a theoretical question, like what seems to have happened with ventilators in the US. This is happening now. Hospitals right now have limited courses of remdesivir. For example the University of Pittsburgh hospital system has about 50 courses of remdsivir. They expec…
 
Immune Checkpoint Inhibitors. They are revolutionary and transforming cancer care. They shrink tumors and extend lives. Plus they have a better side effect profile than traditional therapies for conditions like metastatic lung cancer, so when those with really poor performance status can't tolerate traditional chemotherapy, immune checkpoint inhibi…
 
This is one of the biggest questions I get, "how are death doulas and hospice different?" Or, "why would someone need an end of life doula when there is hospice?" Or, "are death doulas competing with hospice?" These are variations of the same question. Listen in as I give you a foundation of what role each plays.…
 
As Ashwin Kotwal and Lynn Flint note in the introduction to their Annals of Internal Medicine essay (https://www.acpjournals.org/doi/full/10.7326/M20-1982?journalCode=aim), one year ago people were outraged at the thought of a physician using video to deliver bad news to a seriously ill man in the ICU. And look at where we are today. Video and tele…
 
Parkinson disease affects 1% to 2% of people older than 65 years. Most known for its distinctive motor symptoms, other distressing symptoms are pain, fatigue, depression, and cognitive impairment. About 2/3rds of individuals with Parkinson's will die from disease-related complications, making it the 14th leading cause of death in the United States.…
 
End of Life Doulas are in a new time, incorporating all that is occurring due to the pandemic. New discussions evolve daily, weekly, and will continue to do so. We are out of the shock of it all. We are into expansion again. We are trying on how we will move with the times now. In this podcast Deanna shares how the pandemic has affected a death dou…
 
5 Important things a Death Doula must know to help their professional practice are: 1) Get the word out about your service before every little thing is in place; 2) Know, inside and out, what the #1 tool of the trade is and take great care of it; 3) ... go to our blog post to read the rest, better yet, listen in or even better, watch the video! ble…
 
One million inpatient falls occur annually in U.S. acute care hospitals. Sitters, also referred to as Continuous Patient Aids (CPA's) or safety attendants, are frequently used to prevent falls in high-risk patients. While it may make intuitive sense to use sitters to prevent falls, it does beg the question, what's the evidence that they work? We di…
 
We review the inpatient management in HFrEF, role of GDMT initiation & HF exacerbating drugs. We end the episode with a discussion on HFpEF & device therapies with Professor Carolyn Lam, a Senior Consultant of the National Heart Centre, Singapore and Professor of Duke-NUS Cardiovascular Academic Clinical Program. Listen, Like, Subscribe, and give u…
 
We are rationing in the US. We may not be explicitly rationing, as we're going to discuss on this podcast, but we are rationing - in the way we allocate fewer tests and less PPE to nursing homes compared to hospitals, in the way we allow hospitals and states to "fend for themselves" resulting in those hospitals/states with better connections and mo…
 
The cross-over episode is an American tradition that is near and dear to my heart. My childhood is filled with special moments that brought some of my very favorite characters together. Alf crossed over with Gilligan's Island. The Fresh Prince of Bel Air crossed over with The Jeffersons. Mork and Mindy crossed with Happy Days and Laverne and Shirle…
 
As you study the 3 keys to starting your end of life doula practice, you may feel awkward right now, but over time, as you learn more about these principles and practice them, you will feel better. I promise! It's not rocket science to accompany the dying, it is a human endeavor, natural to us--it is something we have always done. However, if you w…
 
We are delighted to have Dani Chammas, psychiatrist and palliative care physician, back on the GeriPal podcast to talk about emotional PPE. None of us can recall who originated the term, but we've all heard it bandied about much needed for front line providers treating patients with coronavirus. Headlines about the New York emergency room doctor co…
 
What's the role of geriatrics and palliative care in the care of individuals with COPD? We talk this week with Anand Iyer, the lead author of this weeks JAMA IM article on this subject. It's a little off from our ongoing COVID topics, but given that his along with his co-authors (Randy Curtis and Diane Meier) JAMA IM piece just got published, we fi…
 
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