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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. CME available!
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Stay uptodate with the latest in heart failure, cardiac hemodynamics, pulmonary hypertension and cardiac transplantation.
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The Promise and Pitfalls of AI in Medicine: Bob Wachter
44:32
44:32
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Eric asks the question that is on many of our minds - is the future of AI more Skynet from Terminator, in which AI takes over the world and drives humanity to the brink of extinction, or Wall-E, in which a benevolent and empathetic AI restores our humanity? Our guest today is Bob Wachter, Chair of Medicine at UCSF and author of the Digital Doctor: …
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Ambivalence in Decision-Making: A Podcast with Joshua Briscoe, Bryanna Moore, Jennifer Blumenthal-Barby & Olubukunola Dwyer
51:34
51:34
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Ambivalence is a tough concept when it comes to decision-making. On the one hand, when people have ambivalence but haven't explored why they are ambivalent, they are prone to bad, value-incongruent decisions. On the other hand, acknowledging and exploring ambivalence may lead to better, more ethical, and less biased decisions. On today's podcast, J…
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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand
48:30
48:30
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48:30
In 1983, a 25 year old Nancy Cruzan was thrown from her car while driving home in Missouri, landing in a water filled ditch. She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that…
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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen
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39:41
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One marker of the distance we’ve traveled in palliative care is the blossoming evidence base for the field. Ten years ago we would have been hard pressed to find 3 clinical trial abstracts submitted to the annual meeting, much less high quality randomized trials with robust measures, sample sizes, and analytics plans. Well, as a kick off to this ye…
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Electronic Frailty Indexes: Kate Callahan, Ariela Orkaby, & Dae Kim
44:21
44:21
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What is frailty? Kate Callahan relates a clear metaphor on today’s podcast. A frail person is like an origami boat: fine in still water, but can’t withstand a breeze, or waves. Fundamentally, frailty is about vulnerability to stress. In 2021 we talked with Linda Fried about phenotypic frailty. Today we talk with Kate Callahan, Ariela Orkaby, & Dae …
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Dysphagia Revisited: A Podcast with Raele Donetha Robison and Nicole Rogus-Pulia
46:49
46:49
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Almost a decade ago, our hospice and palliative care team decided to do a “Thickened Liquid Challenge.” This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. The rules of the challenge were simple: fluids must be thickened to “honey consistency” using a beverage thic…
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End-of-Life Doulas: A Podcast with Jane Euler, Beth Klint, and John Loughnane
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43:05
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In the last several years, I’ve seen more and more articles about end-of-life doulas (like this NY Times article from 2021). Despite this, in my 20-year career as a palliative care physician, I have yet to see a death doula in the wild. I’m unsure what they do, how often they’re used, and who pays for their work. So, on today’s podcast, we try to g…
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GeriPal 300th Episode: Ask Me Anything Hot Ones Style
43:48
43:48
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Today we celebrate eight years, around 2 million listens, and 300 podcasts! Eric and I take questions from you, our listeners, about: why we podcast, our most controversial podcast, which podcast changed our practice, favorite song request, should all nursing home residents complete the POLST, expanding access to durable medical equipment, palliati…
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Psychological Issues in Palliative Care: Elissa Kozlov and Des Azizoddin
45:44
45:44
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In our podcast with palliative care pioneer Susan Block, she identified the psychological/psychiatric aspects of palliative care as the biggest are of need for improvement. As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. That rings true to me. Toda…
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EMS Intervention to Reduce Falls: Carmen Quatman and Katie Quatman-Yates
45:33
45:33
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We've talked about Falls a couple of times on this podcast, most recently with Tom Gill about the STRIDE study and before that with Sarah Szanton about the CAPABLE study. A takeaway from those podcasts is that fresh innovative thinking in the falls prevention space is welcome. Today we talk with the twin sister power duo of Carmen Quatman and Katie…
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The Nature of Suffering: BJ Miller and Naomi Saks
52:27
52:27
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In 1982 Eric Cassell published his landmark essay: On the Nature of Suffering and the Goals of Medicine. Though his narrow definition of suffering as injured or threatened personhood has been critiqued, the central concept was a motivating force for many of us to enter the fields of geriatrics and palliative care, Eric and I included. Today we talk…
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RCT of Default Inpatient PC Consults: Kate Courtright & Scott Halpern
47:19
47:19
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Last week we talked about a trial of a nurse and social worker outpatient palliative care intervention published in JAMA. This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. (See also our accompan…
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RCT of Palliative Care for Heart Failure and Lung Disease: David Bekelman and Lyndsay DeGroot
51:50
51:50
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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. The article we discuss today, also published in JAMA…
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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check
52:28
52:28
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The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. In doing so, it seems to give the impression that pain seen in cancer is inherently different than pain seen in other conditions and that those with cancer may not have the same risk for opioid use disorder…
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What is going on with MAID in Canada? Bill Gardner, Leonie Herx, & Sonu Gaind
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52:45
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Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). Four percent. The number of people who have used MAID in Canada since it was legalized in 2016 has increased year on year from about 1,000 people in the first year to over 13,000 people in 2022. California, which has a similar population size as Canada and legalized MAI…
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Guiding an Improved Dementia Experience (GUIDE) Model: A Podcast with Malaz Boustani and Diane Ty
53:16
53:16
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53:16
We’ve talked a lot about comprehensive dementia care on the GeriPal podcast but while the evidence is clear that these programs work, the uptake has been limited largely because there hasn't been a strong financial case for it. Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS ed…
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Influence of Hospital Culture on Intensity of Care: Liz Dzeng
47:12
47:12
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One of the things I love about Liz Dzeng’s work is the way in which it draws upon, echoes, and advances our understanding of the influence of culture on the end of life experience. This field is not new. In his book The Hour of our Death Philip Aries described a long evolution in western civilization of cultural attitudes towards dying. More recent…
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