show 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.
 
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show series
 
Sometimes being an advocate for a loved one includes voicing concerns and complaints. Knowing who to talk to and how to do it is important. It’s a good idea to start with the case manager from your hospice team. If that doesn’t work, voice your concern to the director or administrator. Escalate your complaint if there’s not an appropriate response …
 
One of our earliest COVID podcasts with Jim Wright and David Grabowski a year ago addressed the early devastating impact of COVID on nursing homes. One year ago Mike Wasserman, geriatrician and immediate past president of the California Long Term Care Association, said we’d have a quarter million deaths in long term care. A quarter of a million dea…
 
If you’re a caregiver, you’re an advocate for your loved one. Knowing what records to keep is important. Some things need to be saved, some can be shredded. If you stay organized, you’ll be able to find the documents you need in a crisis. A few of the items you want to make sure you keep are a current medication list, a healthcare history, and all …
 
There’s more than meets the eye when it comes to the role of the hospice chaplain. In this episode we’re talking with hospice chaplain and Jewish Rabbi David Gold. David gives insight into the work of hospice chaplaincy and shares the traditions that affect how Jewish patients and families experience death and dying. There seems to be a lot of conf…
 
In the 2nd episode of our Patient Advocacy Series, we’re talking about how to get the best results from interactions with healthcare professionals. Before appointments, it’s important to write down any questions you have. Even if the patient can make his own decisions, it’s useful to have another set of ears. The patient should be allowed to respon…
 
COVID has taken a devastated toll in nursing homes. Despite representing fewer than 5% of the total US events, at least 40% of COVID‐19–related deaths occurred in older individuals living in nursing homes. The good news is that with the introduction of COVID vaccines in nursing homes, numbers of infections and outbreaks have plummeted. However, onl…
 
Being a healthcare advocate for someone you love can be challenging. In the first episode of our Patient Advocacy Series, we’re talking about...talking. Communication is key. Everyone needs an advocate, someone who can keep track of information and coordinate with the healthcare team. The exchange of information during serious illness can be overwh…
 
Hospice may not be a great match for all of the care needs of people with dementia, but it sure does help. And, as often happens, when patients with dementia do not decline as expected, they are too frequently discharged from hospice, an experience that Lauren Hunt and Krista Harrison refer to in an editorial in the Journal of the American Geriatri…
 
The Grief Recovery Institute estimates grief costs U.S. business close to $100 billion annually. Anthony and Guy Casablanca at Grief Leaders have written the book that every leader needs. The Dying Art of Leadership: How Leaders Can Help Grieving Employees Excel At Work is the resource that any manager or leader needs to support struggling team mem…
 
Being the new kid is never fun. It takes adequate training and lots of support to ensure the success of new hospice team members. When someone is orienting to agency processes and policies, coworkers need to be patient and be willing to answer questions. Reducing staff turnover is important not only to agency culture, but to team culture as well. A…
 
Are you making the most of your hospice team meetings? We’ve got some great tips for keeping your discussions professional and respectful. Using derogatory terms or labels to describe patients and families will eventually find its way into your care so keep your reporting respectful. It’s also important to remember to allow time for every team memb…
 
The COVID pandemic brought to light many things, including how society views older adults. Louise Aronson wrote a piece in the NY Times titled “‘Covid-19 Kills Only Old People.’ Only? Why are we OK with old people dying?”. The ageist viewpoint she was rallying against was also brought to light in a study of ageism in social media. When looking at t…
 
Volunteers hold a special place in hospice care. Musician Steve Litwer is sharing the stories of his patients, and how he found healing for himself from those who couldn’t be healed. In his book “The Music Between Us: Memoir of a Bedside Musician” Steve tells how we connect with music on a deep level through the years of our lives. After retiring f…
 
Comfort kit, comfort pack, e-pack. No matter what you call it, the set of medications used by some hospice agencies can be a great tool to manage symptoms in urgent situations. Not every agency uses a comfort kit. Typically a kit is composed of medications for issues like shortness of breath, fever, anxiety, pain, or nausea. There’s no set rule abo…
 
So what exactly does a hospice medical director do? Why do some choose to become hospice physicians? What additional training is needed, if any, beyond Hospice and Palliative Medicine fellowship and boards? Who should take the new Hospice Medical Director Certification Board Examination? A recent study in JAGS found high rates of hospice disenrollm…
 
Do you think your advance care plan is complete? It’s way more than a one and done conversation! Along with the big decisions like your health care proxy and resuscitation status, there are lots of details to communicate to your healthcare providers, your proxy, and your family. It’s important to know what’s legally acceptable in the state or provi…
 
Where are we with Alzheimers? Are we about to see a revolution in how we diagnose and treat it with Amyloid PET scans and the amyloid antibody aducanumab (which is currently on FDA’s desk for approval)? Or are we still in the same place where there is no meaningfully effective treatment? Or is it somewhere in between, given the data that we have on…
 
When Sherrie Dunlevy experienced the death of her infant son, she learned the hardest lessons that grief can teach. As a best selling author, speaker, and coach, she now guides grieving women to live their best lives. Her book “How Can I Help? Your Go-To Guide for Helping Loved Ones Through Life’s Difficulties” offers actionable solutions for being…
 
Businesses in the U.S. lose $75 billion annually in productivity related to grieving employees. Anthony and Guy Casablanca of Grief Leaders are equipping leaders to provide the support that staff dealing with grief need. That grief isn’t limited to a death loss, but can also be related to divorce, addiction, financial problems, and chronic or serio…
 
Nursing home residents have been devastated by COVID. Somewhere around 40% of deaths from COVID have been among nursing home residents, though they make up just a sliver of the US population. Prognostication among nursing home residents who have COVID is important for a host of reasons - for counseling patients and families about what to expect, fo…
 
Author Steve Litwer shares stories of his hospice volunteering as a bedside musician in his new book “The Music Between Us: Memoir of a Bedside Musician”. Serving others by playing his guitar helped him find healing and perspective for his own life. His connections with his hospice patients motivated him to share their stories along with his own. S…
 
End of life issues are complicated. Mediator and patient advocate Althea Halchuck of Ending Well Patient Advocacy talks with us about the challenges she sees people face. According to her website, Althea has been advocating for the vulnerable and the dying for over 20 years. She has mediated in LA County “helping seniors challenge bill collectors a…
 
Help The Heart of Hospice share the love with healthcare workers to celebrate Valentine’s Day! Send a message of gratitude and encouragement to 3 of your favorite healthcare people during the week of Feb. 8-14. The people who care for us, our families, and communities have worked harder than ever in the last year. Show them how much you appreciate …
 
Lesbian, gay, bisexual and transgender (LGBT) older adults have lived through a lifetime of discrimination, social stigma, prejudice, and marginalization. Is the care that we are giving them in later life changing any of that or are we pushing them back into the closet? This is what we talk about in this week's podcast with Carey Candrian from the …
 
The Family Caregiver Alliance is a great resource if you’re one of the 42 million personal caregivers across the U.S. Whether you need information on caring for someone with dementia, resources for advance care planning, or patient advocacy, the FCA website can help you. According to the FCA website, “The mission of Family Caregiver Alliance (FCA) …
 
On the one hand, every year we are fortunate to have new medications that help older adults and people living with serious illness. New treatments for lung cancer with remarkable survival outcomes come to mind, for example. On the other hand, the tremendous growth in medications has led to an explosion of prescribing, polypharmacy, with attendant s…
 
Dr. Jeff Spiess knows the ins and outs of end of life care as a hospice medical director. He shares his wisdom in a great discussion about hospice, care transitions, and the obstacles to creating advance care planning. Dr. Spiess’s book “Dying with Ease - A Compassionate Guide to Making End-of-Life Decisions” is a must-read for anyone who is dealin…
 
Most of us know we are going to die. How often though do we actually let ourselves really internalize that understanding? To imagine it? To feel it? To try to accept it? On today’s podcast we invited BJ Miller back on our podcast to talk about death using as our guide his recent NY Times editorial What Is Death? How the pandemic is changing our und…
 
We’re flexing our gratitude today to get 2021 started. There’s no easier way to boost your self care wellness than practicing thankfulness. We all know 2020 was challenging and at times, even heartbreaking. In this New Year’s message, Helen and Jerry remember all the ways the past year helped us to grow. Our Connection Moments campaign allowed us t…
 
Many of us in geriatrics and palliative care assume that we are the experts in health care when it comes to understanding the caregiver experience. Every once in a while, we are humbled and reminded of what we don’t know. Jessica Zitter had such an experience. Jessica, as many of you know, is an award winning author (link to our podcast about her b…
 
Welcome to our first podcast of 2021! We couldn’t have asked for better guests than the creators of The Death Deck. Lori Locicero and Lisa Pahl share with Jerry and Helen how they teamed up to create a set of cards that work as conversation starters for end of life wishes. Using humor, reflection, and creativity, The Death Deck makes us think about…
 
Hospice agencies care for their patients all day, every day. What should patients and caregivers expect from on call services during the night, weekends, or on holidays? We’re talking about “on-call” services in today’s episode. Being a seriously ill person or a caregiver for someone who’s seriously ill is very isolating. It can feel like there’s n…
 
Music can improve quality of life for people experiencing a serious illness. The American Palliative Music Council provides “complementary and alternative uses of music in palliative care treatment for persons and families coping with serious illness from the time of diagnosis.” Under the leadership of Certified Palliative Music Planner™ (CPMP) Gle…
 
Surrogate decision‐making around life-sustaining treatments in the hospital even in the best of circumstances is hard. It’s maybe even harder when caring for those who are conserved or have a professional guardian. The conservator may not have known the patient prior to them losing capacity, they may not know their values or goals that can help gui…
 
You’ll love the energy of this episode’s guest - Traveling Caregivers founder Dawn Renee. For the last 5.5 years Dawn has been a live-in caregiver caring for a friend with stage 4 ALS, Amyotrophic Lateral Sclerosis (aka Lou Gherig’s disease). Navigating caregiving at whatever level you are needing can easily be one of the most challenging tasks you…
 
We’re overdue for a self care check in, so in today’s episode Jerry and Helen are sharing the good and bad of their self care for the holiday season. The last few months of the year can be a time of unhealthy eating, extra commitments, and short sleep. All the “extras” can take a toll on our self care. It’s important to remember that it’s so much h…
 
“Diagnose and adios.” That’s the sad phrase that I’ve heard quoted more than once, representing caregivers' sentiment of what it’s like to be told by a clinician that your loved one has dementia. This week we talked with Zaldy Tan, Geriatrician and Director of the Memory and Aging program at Cedars Sinai in Los Angeles. With David Reuben at UCLA an…
 
Feeling a little stressed by the holiday season? Jerry and Helen talk about having a plan to keep yourself healthy - body, mind, and spirit. While all the holiday fun is tempting, it’s a good idea to keep some balance with your habits. Self care is so important! Stick with routines for sleep and nutrition. Find ways to feed your spirit even if your…
 
What does it mean to create a cultural shift to the end of life experience? Is it even possible? How do you even start something like that? On today's podcast, we talk to Shoshana Ungerleider about her experience making that change. Shoshana is one of those amazing advocates for palliative and end of life care. She started the Ungerleider Palliativ…
 
Bereavement is an often overlooked part of hospice care. Today we’re talking with bereavement counselor Isabel Stenzel, discussing the importance of the bereavement care hospice agencies provide after the death of a patient. Our special guest is Isabel Stenzel. Isabel is an author, bereavement social worker, health educator, and patient advocate. S…
 
Ageism is an ugly reality in the U.S. healthcare system. Today we’re talking about how you can identify ageism in how you talk to and care for your patients. Healthcare providers often speak to older patients as if they were children, or incapable of understanding details about treatments or diagnoses. Speaking in a way that is patronizing or conde…
 
The 2020 holidays are going to feel different, especially for people who are grieving the death of a loved one. The loss of someone you love along with changes due to the pandemic can make it necessary to create some new traditions. You don’t have to let go of the rituals that you love, just find new ways to add meaning. If you’re not able to trave…
 
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…
 
Vital Decisions knows how important it is to decide and document advance care plans before a crisis arises. CEO Leah Puccio shares the mission of the company, and how their skilled clinicians assist individuals to make their wishes known. Vital Decisions has helped over 300,000 people to consider their end of life wishes and get them written down i…
 
The Dougy Center for Grieving Children helps to meet the unique grief needs of children and teenagers. Today we’re talking about all the resources the Center has to support parents, educators and communities as they care for grieving kids. According to the Dougy Center website, the organization “provides support in a safe place where children, teen…
 
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, …
 
Deciding what hospice agency to use can be challenging. The Care Compare website from the Centers for Medicare and Medicaid Services (CMS) can help. Care Compare (previously Hospice Compare) offers information about individual agencies, including consumer survey results, the typical diagnoses for which the agency provides care, and contact informat…
 
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…
 
Matthew Curlewis’s heart shines in today’s episode. You won’t want to miss the wisdom he shares about his caregiving experience with his terminally ill father. The restrictions of the corona virus complicated the anticipatory grief Matthew and his family experienced. He shares what he’s learned about collaborating with a healthcare team and being a…
 
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