197 episodes

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.

GeriPal Alex Smith, Eric Widera

    • Health & Fitness
    • 4.9 • 8 Ratings

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.

    Burnout and Resiliency: A Podcast with Janet Bull and Arif Kamal

    Burnout and Resiliency: A Podcast with Janet Bull and Arif Kamal

    In today’s podcast, we talk with Janet Bull and Arif Kamal about what we can do to address burnout and increase resiliency, both from an institutional and individual perspective. Janet Bull is the Chief Medical Officer and Chief Innovations officer at Four Seasons Hospice and Arif Kamal is an oncologist, palliative care doctor and researcher at Duke.

    • 43 min
    Spiritual Care in Palliative Care: A Podcast with Allison Kestenbaum, Katy Hyman, and Paul Galchutt

    Spiritual Care in Palliative Care: A Podcast with Allison Kestenbaum, Katy Hyman, and Paul Galchutt

    On today’s podcast, we break down spiritual care in palliative care with three leaders in the field: Allison Kestenbaum, Katy Hyman, and Paul Galchutt.

    • 48 min
    Every deep drawn breath: Podcast with Wes Ely

    Every deep drawn breath: Podcast with Wes Ely

    We talk with Wes Ely about his book (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 lifelong physical, cognitive, and psychological harm; and the arc of his redemptive journey to find a better way to care for patients in the ICU. We are joined today by Lekshmi Santhosh, head of UCSF’s post-COVID and post-ICU clinic, to interview Wes about these themes that animate his book.

    • 52 min
    The Messiness of Medical Decision Making in Advanced Illness: A Podcast with James Tulsky

    The Messiness of Medical Decision Making in Advanced Illness: A Podcast with James Tulsky

    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. 
    We talked about James’ path to the work that he has done, including early studies he did that included audio recording DNR discussions between physicians and patients, to his most recent study looking at the “Triadic agreement about advanced cancer treatment decisions.”   
     
    In this last study, James’ group surveyed 70 triads of patients, caregivers, and their oncologists shortly after making a cancer treatment decision and found that only 40% of triads completely agreed on the goal of treatment. In all of the remaining cases, at least one member of the triad disagreed about the goal of treatment. 
    So take a listen and also check out this wonderful ACP article that James did with Joshua Lakin and Rachelle Bernacki titled “Time Out Before Talking: Communication as a Medical Procedure” which we also discuss on the podcast. 

    • 45 min
    Reducing Prolonged Admissions: Podcast with Kenny Lam, Jessica Eng, Sarah Hooper, and Anne Fabiny

    Reducing Prolonged Admissions: Podcast with Kenny Lam, Jessica Eng, Sarah Hooper, and Anne Fabiny

    “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 successful interdisciplinary intervention to reduce prolonged admissions, published in NEJM Catalyst.  Many of the problems that older adults face are not medical.  How to find housing.  How to stay in their homes.  How to get a paid caregiver to help them stay at home.  How to get someone to pay bills.  How to assign a surrogate health care decision maker.  The legal obstacles to accomplishing these tasks for complex older adults, particularly those who may have marginal decision making capacity, can seem insurmountable.  Having a lawyer on the team is brilliant - in much the same way that having a handyperson on the team for project CAPABLE to keep people at home was brilliant.  For more, listen also to our prior podcast with Sarah Hooper on medical-legal partnerships.

    • 44 min
    Meaningful Activities: Podcast with Anna Oh and Theresa Allison

    Meaningful Activities: Podcast with Anna Oh and Theresa Allison

    Most studies in geriatrics have used metrics such as survival time or disability in activities of daily living as their outcome measure.  Many palliative care interventions are evaluated on the basis of ability to change symptoms such as pain.  But these outcomes represent a thin view of the human experience.  What older adults and those with serious illness often care about most is being able to do the activities that animate their lives with meaning and purpose.  Participating in meaningful activities is central to quality of life, and yet is poorly captured in most outcome scales.
    In this week’s podcast, Ken Covinsky joins Eric Widera and I to talk with Anna Oh and Theresa Allison, two researchers who have taken very different approaches to studying meaningful activities.  Anna conducted a quantitative study, getting a 30,000 foot view of older adults with dementia, disability, and depression’s ability to participate in meaningful activities.  Most people think that a good quality of life isn’t possible for people with these conditions. Anna’s study, published in JAMA IM, finds that most older adults with these conditions are still engaging in meaningful activities.
    Theresa’s qualitative study, published in JAMDA, delves deep into the lived experience of older adults with dementia and their caregivers. She finds that while they have had to adapt to support participation in meaningful activities, the underlying sources of meaning have remained the same.  Interestingly, caregiver stress was higher when the people with dementia they cared for stopped participating in meaningful activities.  Helping people with dementia and caregivers adapt to continue to engage in meaningful activities is a creative activity that is at the heart of good geriatric and palliative care.
    -@AlexSmithMD
     

    • 42 min

Customer Reviews

4.9 out of 5
8 Ratings

8 Ratings

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