VeriGeri

Patricia Lee, MD, and Samantha Ing, MD

We cover the bread and butter and beyond of Geriatrics with willing gurus. Geared for the med student, resident, geri fellow, a fellow fellow who takes care of older adults, or PCP or internist who, like us, just want to sharpen our care for the older adult. Disclaimer! Views and thoughts expressed are our own & are not associated with any institutions. Please always consult your physician for medical advice.

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    #19: Driving Retirement: When and How to Talk About It

    Ope, we're back! Sorry for our lil hiatus as Patty was getting used to her new job. Well guess what? We did NOT hold back this episode. We talked with Geriatrician Dr. Emily Morgan on when to assess and communication tips, Occupational Therapist/certified driving rehab specialist Marisa Palandri for a backseat look on how driving rehab sessions work, and Social Worker Tessa Garcia McEwen on more communication tips for anticipated detours and possible potpholes, with how to have transportation replacement at the ready. We know that this is a gnarly topic because state guidelines differ, but we feel that it's important to have these ready to go for all patients. Disclaimer: Don't take any medical advice from this podcast . Always consult with your own physician on your medical decisions, and this podcast is not affiliated with any universities. Thoughts and views are our own. Guest Bios: Emily Morgan, MD is a graduate of Oregon Health and Science University Medical School, where she stayed on to complete her internal medicine residency, followed by a fellowship in geriatrics. She is currently an Associate Professor of Internal Medicine and Geriatrics at OHSU where she has a geriatric primary care practice. In addition to her outpatient work, she is the head of the OHSU Internal Medicine Post-Acute and Long-term Care (PALTC) team and is Medical Director of Mirabella Portland PALTC. Her research focus is on improving geriatrics care in primary care and PALTC settings.  Marisa Palandri, OT, CDRS completed her undergraduate degree at Portland State University and earned her Master's Degree in Occupational Therapy from Pacific University in 2011. Since then, she has worked for Shepherd Center in Atlanta, Georgia, helping adults and teenagers with spinal cord injuries, strokes, and brain injuries learn how to regain their independence. She earned her certified driver rehabilitation specialty in 2018 to be able to help those same clients with neurologic injuries. She is  the President of Bridges, a nonprofit that helps give more access to driving evaluations and specialty training for individuals all over the state of Oregon. Tessa McEwen, AM, LCSW, DCCS, CDP has 20+ years of experience supporting diverse populations across nonprofit and medical settings, with a focus on personalized care and intergenerational connection. At UChicago Medicine, she primarily supports patients and families living with Alzheimer's disease and related dementias—working through the Memory Center and consulting across outpatient neurology and neurosurgery clinics. She is a global facilitator for Lorenzo's House, co-leading programs for youth and care partners impacted by dementia. A Schweitzer Fellowship recipient, Tessa centers grief support, cultural humility, and compassionate care. She co-founded Dementia Friendly Hyde Park, holds a BA in Sociology from the University of Notre Dame, and an MSW from the University of Chicago. Guest Host Bio:  Megan Teramoto, BS, MS, is a first year medical student at the Pritzker School of Medicine. She received her Bachelor's and Master's degrees after studying Biochemistry at the University of Arizona. Outside of school, Megan enjoys volunteering and hiking.    Follow our Instagram, @verigeripodcast:  https://www.instagram.com/verigeripodcast Please subscribe to our podcast to get the word out! Show Notes: https://verigeripodcast.com/show-notes/f/driving-retirement-when-and-how-to-talk-about-it Timestamps 00:00 Driving Retirement Intro   00:23 Meet The Guests   01:45 Show Disclaimer   02:21 Warmup Game   03:56 Why Driving Safety Matters   06:34 Case One Routine Screening   09:33 Case Two Memory Concerns   12:48 Red Flags And Referrals   19:15 OT Driving Rehab Explained   23:38 Driving Outcomes Checklist   24:47 Behind The Wheel Context   26:00 Retesting And Provider Questions   26:57 Four Results Recap   27:51 Alzheimers Case Setup   28:42 MoCA And Framing   31:44 No Reporting Language   32:10 Social Worker Strategies   33:50 When Patients Refuse   37:37 Keeping Cars Inaccessible   38:46 Independence Without Driving   40:19 Local Transport Programs in Chicago   44:00 Key Takeaways And Closing   Co-Producers: Patty Lee, MD, Sam Ing, MD, Megan Teramoto, BS, MS Script Writer: Megan Teramoto, BS, MS Primary Editor: Patty Lee, MD Show Notes Writer: Patty Lee, MD

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    #18: CALL YOUR GRANDMA! Why loneliness in older adults is more than just being alone with Dr. Ellie Fishbein - @Geriatricsinreallife

    In this episode, we sit down with Dr. Ellie Fishbein, AKA @Geriatricsinreallife / Survivor extraodinaire / Improv extraodinaire / TikTok/Insta famous geriatrician to talk about loneliness and what to practically do about it. Oh, and we toss in a teensy Mad Lib.  Guest Bio: Dr. Ellie Fishbein is an Assistant Professor of Medicine in Geriatrics at Washington University School of Medicine. She earned her MD from Rush Medical College and completed her Family Medicine Residency and Geriatrics Fellowship at the University of Iowa Hospitals and Clinics. Dr. Fishbein is board-certified in Family Medicine and has a focus on geriatric care, providing comprehensive assessments and mentorship to residents. Her clinical expertise includes continuity of care and interdisciplinary approaches to managing complex geriatric conditions. She is also a recognized educator, receiving the 2024 Resident's Teacher of the Year Award. Dr. Fishbein is the creator of @geriatricsinreallife, a widely followed educational platform on Instagram and TikTok, known for its practical and creative infographics that make complex geriatric concepts approachable for learners and clinicians alike. Dr. Ellie's Instagram, @geriatricsinreallife: https://www.instagram.com/geriatricsinreallife  Dr. Ellie's TikTok, @geriatricsinreallife:  https://www.tiktok.com/@geriatricsinreallife  Follow our Instagram, @verigeripodcast:  https://www.instagram.com/verigeripodcast Please subscribe to our podcast to get the word out! Show Notes: https://verigeripodcast.com/show-notes/f/18-call-your-grandma  Timestamps 00:44 Introductions 03:54 Defining loneliness, social isolation 07:08 Prevalence and health implications of loneliness 09:55 Case  15:32 Screening for loneliness in older adults 21:39 The 5 Ms 30:48 Mad Lib reveal   Co-Producers: Sam Ing, MD, Patty Lee, MD, Hannah O'Hagan, MD Script Writer: Hannah O'Hagan, MD Primary Editor: Sam Ing, MD Show Notes Writer: Kylie McElheran, BS Graphic designer: Patty Lee, MD

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    #17: Dear Patients & Families: Stretching the Dollars of Dementia with Tessa Garcia McEwen, AM, LCSW, DCCS, CDP

    While our episodes are usually clinician-facing, our series of "Dear Patients and Families" are also patient-facing! This is the second episode in this series. Our first episode was #11: Dear Patients and Families: How to Navigate Dementia During the Holidays. This episode looks at how to proactively take steps to plan and save money when a diagnosis of dementia is given. No matter what age we are, it can be intimidating to navigate finances of the healthcare system. Tessa tells us how to plan ahead. We go over a general acronym of approach, power of attorney roles, looking for in-home and out-of-home support, when care needs to escalate.  We're proud that this episode was written by Kylie McElheran, a medical student at OHSU, with awesome show notes and graphics all made by Jai Daniels, a medical student at University of Chicago. Click here for SHOW NOTES! Timestamps ● 00:00 Welcome & disclaimer; why finances surface after a new dementia diagnosis ● 04:00 The DIGNITY framework (Designate, Independence, Gather, Needs, Intentionality, Therapies, YOLO) ● 09:14 Healthcare vs. Financial Power of Attorney (differences, notarization, when to involve elder law) ● 10:42 Avoiding guardianship: costs, risks, and why early POA saves money and strain ● 13:34 Price Is Right safety items & costs (hearing amplifier, light bars, shower chair, bidet, fall-detect watch) ● 15:00 Subsidized in-home supports: homemakers, adult day, caregiver respite; paying a family caregiver ● 20:00 When home isn't enough: assisted living, supportive living (Medicaid), and memory care ● 27:30 Building a care mosaic (family/friends + subsidized hours + targeted private-pay gaps) ● 27:50 Finding & vetting facilities; waitlists; concierge placement services; planning "six months private-pay" to access a Medicaid bed ● 30:43 Life insurance hack: accelerated death benefits ● 31:18 Communication about finances: "Is the current plan working?"; gentle language about moving Guest Bio: Tessa McEwen, LCSW has 20+ years of experience supporting diverse populations across nonprofit and medical settings, with a focus on personalized care and intergenerational connection. At UChicago Medicine, she primarily supports patients and families living with Alzheimer's disease and related dementias—working through the Memory Center and consulting across outpatient neurology and neurosurgery clinics. She is a global facilitator for Lorenzo's House, co-leading programs for youth and care partners impacted by dementia. A Schweitzer Fellowship recipient, Tessa centers grief support, cultural humility, and compassionate care. She co-founded Dementia Friendly Hyde Park, holds a BA in Sociology from the University of Notre Dame, and an MSW from the University of Chicago.Guest-Host and Writer Bio: Kylie McElheran, BS, grew up in Grants Pass, OR, and is now a third-year medical student at Oregon Health & Science University in Portland, OR. Before medical school, she worked in the clinical research industry for 6 years. In her free time, she loves hanging with her husband and dog, as well as playing board games while dabbling in Oregon's superb craft beer scene. Co-Producers: Sam Ing, MD, Patty Lee, MD Primary Editor: Sam Ing, MD Graphic designer & Show Notes Writer: Jai Daniels, BA Instagram: https://www.instagram.com/verigeripodcast Please subscribe and rate our show 5 stars - that helps to get the word out for our show.

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    #16: Acute Inpatient Pain in Older Adults Part 2: Beyond Acetaminophen with GeriPal Dr. James Brehany

    WAIT! This is part 2 of non-cancer inpatient pain management in older adults (Part 1 is episode #15 with Dr. Thomas Chen, who talks about the pharmacology/theory of pain medications in older adults - check it out first!). In this episode, we jump into it - GeriPal physician Dr. James Brehany will focus on APPLICATION of foundational concepts. Spoiler alert - we will delve into a case of gabapentin, tramadol, SNRI, buprenorphine, common opioids, and then end with lightning rounds. And before all you palliative care peeps get your pants in a bunch, this episode focuses on NON-CANCER ACUTE INPATIENT PAIN, so you'll have to put that specific thinking cap on first. We don't touch on outpatient pain management, but resources will be on our show notes. Guru Bio: Dr. James Brehany is Assistant Professor of Palliative Medicine at The Ohio State University, board certified in IM, palliative medicine, and geriatric medicine with clinical interests in overlap of addiction/pain, medical student education, and bioethics.  Guest Host Bio: Hannah O' Hagan is an Internal Medicine Resident at the University of Chicago. Show Notes Timestamps 00:00 Introduction and Disclaimers 00:11 Meet the Hosts and Guest 00:26 Journey into Geriatrics and Palliative Care 02:23 Case Introduction: Ms. Peach 04:03 Medication Review and Pain Management 07:24 Deprescribing and Delirium 11:20 Types of Pain and Management 14:14 Creating the Pain Management Plan 30:46 Lightning Round: Quick Fire Questions 34:33 Conclusion and Credits Guru: James Brehany, MD Guest Host: Hannah O'Hagan, MD  Show Notes Editor: Patty Lee, MD Hosts: Patty Lee, MD, Sam Ing, MD

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    #15: Acute Inpatient Pain Management in Older Adults Part 1: Don't Fear the Pharm with Hospitalist Dr. Thomas Chen, MD, PharmD

    Tramadol, cyclobenzaprine, gabapentin, NSAIDs, oh my!  This episode of focuses on pain management in older adults, specifically pharmacological management of non-cancer related acute inpatient pain. This is part 1 of a two-part series. Part 2 will focus on application of pain management with opioids such as buprenorphine, oxycodone, and dilaudid in older adults. We're joined by Dr. Thomas Chen, MD, PharmD, an assistant professor of medicine and hospitalist at the University of Chicago, with expertise in clinical pharmacology and pharmacogenetics. Dr. Chen discusses the pharmacokinetics and pharmacodynamics changes in older adults that affect pain perception and medication efficacy. He also goes over the rationale for the 'start low and go slow' approach, the controversial use of Tramadol, and the pharmacogenomic considerations in prescribing pain medications like hydrocodone, codeine, gabapentin, cyclobenzaprine, and NSAIDs. Dr. Chen also shares his personal experiences and practical advice for managing pain in a hospital setting while emphasizing the importance of de-prescribing unnecessary medications. SHOW NOTES!!!: HERE As we're focused on management of acute inpatient pain in older adults, underutilized outpatient treatments such as CBT, nerve blocks, injections, and physical therapy are not covered. But many tools exist, with examples below - perfect for your next dotphrase: Many of the nonpharmacological options are outlined on geriatricpain.org, with short "Fast Facts" for patients, developed by the University of Iowa Also on geriatricpain.org is a comprehensive, patient-centered Caregiver Toolkit for assessing pain in your family member with dementia. It goes over Pain Assessment in Advanced Dementia (PAIN AD) Tool, Pain Thermometer, Pain Diary, etc. If you don't want to hog the clinic printer by printing that out, healthinaging.org also provides a shorter caregiver guide for pain. This is even shorter. I-COPE Toolkit: https://voices.uchicago.edu/icope/learn-about-i-cope/ To find CBT for pain management, search American Psychological Association with the patient's zip code and practice area of "Pain Management"   Your state or local county Office for the Aging may also be able to provide resources for support groups for chronic pain. Timestamps 00:00 Introduction to Pain Management in Older Adults 01:45 Meet Dr. Thomas Chen: Background and Expertise 04:32 Understanding Pain Perception and Pharmacokinetics in the Elderly 07:13 The Tramadol Debate: To Use or Not to Use? 11:08 Exploring Alternatives: Hydrocodone and Codeine 13:57 Managing Acute Inpatient Pain: Non-Opioid Approaches 20:04 NSAIDs in Older Adults: Benefits and Risks 24:09 The Role of Acetaminophen and Final Thoughts   Guru: Thomas Chen, MD, PharmD Guest Host/Co-Producer: Hannah O'Hagan, MD (University of Chicago IM PGY2) Show Notes Editor: Kylie McElheran, BS (Oregon Health and Science University MS3) Hosts: Patty Lee, MD, Sam Ing, MD     Guru Bio: Dr. Thomas Chen is an Assistant Professor of Medicine in the Section of Hospital Medicine at The University of Chicago, with a secondary appointment with the Committee on Clinical Pharmacology and Pharmacogenomics. Dr. Chen brings valuable experience as a former pharmacist, utilizing his medication expertise to contribute to research, patient care, and education. In addition to his clinical work as a hospitalist, he is the co-director of the Personalized Therapeutics Clinic, where he conducts extensive medication reviews for drug-drug and drug-gene interactions, also known as pharmacogenomics. Dr. Chen actively engages in research within pharmacy-related areas and pharmacogenomics. He was a co-investigator for the NIH-funded study titled, "Implementation of Point-of-Care Pharmacogenomic Decision Support Accounting for Minority Disparities." Currently, he is a co-investigator for a clinical trial, the "PROTECT-Rx: Evaluating the Effectiveness of a Personalized Therapeutics Clinic Intervention on Drug-Drug Interactions and Drug-Gene Interaction." Show Notes Editor Bio: Kylie McElheran, BS grew up in Grants Pass, OR and is now a third-year medical student at Oregon Health & Science University in Portland, OR. Before medical school, she worked in the clinical research industry for 6 years. In her free time, she loves hanging with her husband and dog, as well as playing board games whilst dabbling in Oregon's superb craft beer scene.

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    #13: Refining serious illness conversations: a patient-centered approach with Dr. Paige Barker, MD, Dr. Karen Bullock, PhD, LICSW, FGSA, APHSW-C, and Dr. Carine Davila, MD, MPH

    WHOOOOA! This is a SERIOUSLY SERIOUS EPISODE with powerhouses! In this episode of the VeriGeri podcast, we dive into the framework and nuances of serious illness conversations. Dr. Paige Barker, Dr. Karen Bullock, and Dr. Carine Davila cover the bread and butter of essentials in serious illness conversations but also take us through how to center on the patient with their individual experiences. We apply their foundation through a case in the middle and listen to tips about working with interpreters at the end. Show notes: https://verigeripodcast.com/show-notes/f/serious-illness-conversations-a-patient-centered-approach Graphic Designer & Show Notes Editor: Jai Daniels, BA   Peer reviewers: Jason Lyou, MD, Shaina Fuller, MPH Bios:  Dr. Paige Barker, MD, is a clinician educator in general internal medicine with expertise in palliative care at the University of Florida. She's passionate about teaching palliative skills and improving serious illness communication.  She is the Palliative and End of Life Curriculum Director at University of Florida College of Medicine and leads the Goals of Care workgroup at UF Health.  Dr. Karen Bullock, PhD, LICSW, FGSA, APHSW-C, is a Louise McMahon Ahearn Endowed Professor at Boston College School of Social Work and Global Public Health. She is a clinical social worker with expertise in health disparities, aging, serious illness care, and palliative care. She's led numerous federal grant funded research on equity, workforce development, and health sustainability. She is the John A. Hartford Faculty Scholar and has served on numerous national boards including SWHPN and the ACS Oncology Social Work Research Peer Review Committee. She is also the steering committee member for the Duke University REACH Equity Center and an affiliate faculty at the Center to Advance Palliative Care. She received the AAHPM Richard Payne Outstanding Achievement in Diversity, Equity, and Inclusion Award in 2024.  Dr. Carine Davila, MD, MPH, is a palliative care physician at Massachusetts General Hospital dedicated to improving access to quality care for marginalized populations. She is the equity director for the Division of Palliative Care and Geriatric Care. Medicine and co created the Palliative Care Health Equity Curriculum. Dr. Davila co leads United Against Racism efforts and conducts research on improving serious illness communication for Spanish speaking patients, clinicians, and interpreters.   Timestamps: 00:00 – Introduction to the Episode 00:57 – Meet Our Guest Experts 04:03 – Defining Serious Illness Conversations 08:41 – Asking Permission 10:30 – Thoughtfulness with Historically Marginalized Patients 17:12 – Brief Summary of Serious Illness Conversations 18:23 – Case One: Willie Jenkins 25:33 – Providing Recommendations Based on Patient Values 31:11 – Closing Remarks

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    #12: Sexuality in Aging with Dr. Darlene Moyer and Dr. Travis Glenn

    Just because people are aging doesn't mean they stop wanting or needing intimacy. In this episode, we dive into the often-overlooked topic of sexuality in older adults. Many healthcare providers hesitate to discuss sexual health with aging patients, often assuming they are no longer interested in sex. However, intimacy remains a crucial aspect of overall well-being. Our guests, Dr. Darlene Moyer and Dr. Travis Glenn, help us explore how to better support older patients in maintaining a fulfilling sex life.   Show notes with summary and more detail: https://verigeripodcast.com/show-notes/f/sexuality-in-aging   Episode timestamps 00:00 Introduction to Sexuality in Older Adults 01:01 Meet the Experts: Dr. Moyer and Dr. Glenn 02:40 Medieval Theme and Fun Facts 03:28 Defining Sex and Taking Sexual Histories 08:47 Addressing Sexual Health in Older Adults 09:45 Case One: Erectile dysfunction 15:18 Types of toys 18:37 Case Two: Pain during sex 21:30 Types of lubricants 24:11 Advice 25:36 Episode Recap and Closing Remarks     Dr. Darlene Moyer's Bio: Originally from Pennsylvania, Dr. Darlene Moyer completed medical school at the George Washington University School of Medicine followed by a Family Medicine Residency and Geriatric Fellowship at HonorHealth in Scottsdale, Arizona. Having worked in GME for over 14 years, she is currently an Associate Director at the HonorHealth Family Medicine Residency where she oversees Geriatric training. She practices in the inpatient, outpatient, and long term care settings, and even does home visits with her resident physicians. She is passionate about seeing each patient as an individual who deserves care unique to who they are. Outside of medicine her life is filled with being a mom to her two daughters, hiking, painting, and spending time with her husband, family, and dogs.     Dr. Travis Glenn's Bio: Dr. Travis Glenn and his husband Dr. Bradley Glenn are the physician founders of Glenn Family Medicine on the island of Maui, HI. His training started at the Georgia Institute of Technology followed by medical school at Ross University School of Medicine. He then moved to Arizona to complete residency at HonorHealth in Scottsdale. He previously worked as a hospitalist at Banner University's Phoenix campus, followed by a hybrid inpatient/ outpatient model in Hawaii before focusing on outpatient care and working with medical students from the University of Hawaii. When not in clinic he can usually be found exploring national parks or falling off his paddle board at the beach.     Guest Host Bio: Megan Teramoto, BS, MS, is a first year medical student at the Pritzker School of Medicine. She received her Bachelor's and Master's degrees after studying Biochemistry at the University of Arizona. Outside of school, Megan enjoys volunteering and hiking.      Gurus:  Darlene Moyer, MD, Travis Glenn, MD Guest Host: Megan Teramoto, BS, MS Hosts: Patty Lee, MD, Sam Ing, MD Graphic Designer: Jai Daniels, BA Primary editor: Sam Ing, MD Peer reviewer: Sindhura Vallabhaneni, MD

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We cover the bread and butter and beyond of Geriatrics with willing gurus. Geared for the med student, resident, geri fellow, a fellow fellow who takes care of older adults, or PCP or internist who, like us, just want to sharpen our care for the older adult. Disclaimer! Views and thoughts expressed are our own & are not associated with any institutions. Please always consult your physician for medical advice.