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Rising competition in the hospice space has fueled pivotal changes in end-of-lifecare delivery both for better and for worse, according to Arizona-based Hospice of the Valley Executive Director Debbie Shumway. We also have a home-based primary care practice called Geriatric Solutions. That is the future.
-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of lifecare Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex Smith: This is Alex Smith.
As a result of Mr. McMahon’s successful tenure with the company, he has met the definition of retirement set forth in his previously granted equity awards, which will continue to vest in accordance with their terms, similar to equity awards granted to other employees,” Leong said. “His
Alex 01:56 And returning guest, Vicki Jackson, who’s a palliative care doc, chief of the Division of Palliative Care and Geriatric Medicine at MGH , professor at Harvard Medical School, and co director of the Harvard Medical School center for Palliative Care. And we were able to say, you know, pretty definitively.
Eric 03:35 Well, lets get i nto the topic, and I’m hoping that one of you would be willing to take on m y first question, which comes from a very naive place, is even before we talk about what is trauma informed care, how should we define trauma? Well, being a pretty comprehensive definition. Eric 04:19 Yeah.
We also briefly mention Susan Wong’s terrific studies that found a disconnect between older adults with renal failure’s expressed values, focused on comfort, and their advance care planning and end-of-lifecare received, which focused on life extension; and another study that found quality of life was sustained until late in the illness course.
Our task is simple, we are going to be sampling each of these hot chicken wings while we ask Eric and Alex questions related to Palliative care and Geriatrics. Eric: Definitely MAID- Alex: Eric knows, MAID in Canada Eric: Medical Aid In Dying in Canada. ” And, he said, “End of lifecare.”
The experts settled on a range of key services, from more palliative care focused (e.g. end of lifecare and advance care planning) to more geriatrics focused (e.g. staff training in person centered care). It’s what happens in lots of different fields, including geriatrics. Welcome back.
Alex: Also returning Rebecca Sudore, who is professor of medicine at the UCSF in the division of geriatrics, and is a geriatric and palliative care doctor. I think I’m heartened by the fact that over the last decade or so, the definition of advance care planning has evolved. Welcome back, Rebecca.
Kei Ouchi, associate professor of emergency medicine at Harvard Medical School/Brigham and Women’s Hospital, told Palliative Care News. “So, So, I think they have a harder time involving palliative care initially because they equate palliative care to end of lifecare.
In the US, geriatrics “grew up” as an academic profession with a heavy research base. Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . Palliative care, in contrast, saw explosive growth in US hospitals. I was always critical care bound since medical school.
This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. I’m going to turn to you Lauren.
So we’re going to have a link to the article that you published in JAMA IM titled The Hospital Culture and Intensity of End-of-LifeCare at Three Academic Hospitals. And I was interested in intensity of end-of-lifecare and differences in intensity of end-of-lifecare. Liz: Right.
We have Sarah Nouri, who is a palliative care doc and researcher at UCSF. Alex: And we have Hillary Lum, who is a geriatrics and palliative care researcher at the University of Colorado. Van Scoy who is a pulmonary critical care advance care planning researcher at Penn State Hershey Medical Center in Pennsylvania.
We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Community leaders, and definitely faith community leaders. Who would/should be on that board?
You might be able to extend your life a little bit, but at what cost? So, that was maybe 20 years ago at this point and it really got me down the road thinking about advance care planning, end-of-lifecare, and similar consequences. Yep, for geriatrics? We’re available, palliative care.
Summary Transcript Summary The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-lifecare. Let them have this one piece of joy left, which is their opioid use disorder”, which, by definition, is not bringing them joy, right?
On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Ruth: Sure.
And people are getting life sentences. They’re going to get older, they’re going to struggle with geriatric conditions, and they’re going to need palliative services and eventually end-of-lifecare. It was built in 1955, so it wasn’t designed for a geriatric population.
So I think there’s definitely overlap with that, but I think helping patients cope, make priorities, think through their goals and values early and along the illness course does facilitate and enable better end of life decision making, including advanced care planning.
There was a little bit of teaching about end of lifecare. And for example, there’s still in most medical schools no required rotation in palliative care. I think there’s data that shows that there have been improvements in end of lifecare. And there was some teaching about pain.
You’d imagine that as a seasoned palliative care doc, I’d have a pretty good definition by now of what “maintaining dignity” or “loss of dignity” means, but you’d be sadly wrong. Well that all changes today as we’ve invited the world’s foremost expert in dignity at the end of life, Dr. Here’s a little bit.
Alex: We are so fortunate to be joined by one of my former mentors who I’ve known for 20 years, Holly Prigerson, who is now Irving Sherwood Wright Professor of Geriatrics at Weill Cornell Medical School and Professor of Sociology and Medicine and Director of the Center for Research on End Of LifeCare.
In this PONDER-ICU trial, we didn’t rely on palliative care specialists; we engaged bedside clinicians to have ICU communication and adhere to guidelines. Tom: Do you think they relayed that info to the primary care [inaudible 00:34:14]. Corita: They absolutely did. Tom: No, that makes sense.
While the creative process is what truly matters, we think that the outcome is guaranteed to be awesome and definitely worth sharing. Alex 01:57 And we have Lingsheng Li who is a geriatrics and palliative care doc and illustrator and is currently a T 32 research fellow at UCSF. Frank, welcome to the GeriPal podcast.
Alex 00:27 And we’re delighted to welcome Meredith Green e , a friend, a geriatrician, researcher, associate professor at Indiana University, who was previously with us at UCSF in our division of geriatrics. Eric 00:50 So we’re going to be talking about HIV and geriatrics and palliative care. Meredith 10:53 He was.
I’m the senior nurse educator at H C P, Speaker 1 ( 00:25 ): And you’re listening to Vision, the podcast for leaders and forward thinkers in the care industry. Today we’ll be discussing the importance of unifying the care continuum for end of lifecare. Speaker 3 ( 00:38 ): Hi, glad to be here.
Alex 00:54 And Jasmine Santoyo-Olsson, who’s a social behavioral scientist and a fellow in the T32 Research Fellowship at the UCSF Division of Geriatrics. Danny 07:39 Yeah, definitely. So some of our approaches definitely altered based on the availability of what we could get done. Danny 00:52 Thank you very much.
If we accept that frequent contact with palliative care is the standard of care, and we’re trying to do something that entails less contact or less palliative care, that’s the rationale for it being a non inferiority design, because we have to make the argument it’s no worse. Pallavi 20:28 Yes, definitely.
Alex 00:20 And we’re delighted to welcome in studio Lingsheng Li, who is a geriatrician and palliative care doc and currently a t 32 research fellow in the UCSF division of Geriatrics. And I think what, you know, for when I was there, the asian american veterans, it definitely came up during our visits. Geriatrician?
This really is patients with serious chronic life limiting illness who are hospitalized. Eric: How’d you define serious chronic life limiting? Bob: We used a set of nine conditions that have been used by the Dartmouth Atlas Project to study end of lifecare. I think you had to be age over 55.
She’s a medical anthropologist with an interest in culture of end of lifecare, among other things, and she has a book that is out called Scripting Death: Stories of Assisted Dying in America. Welcome to the GeriPal podcast, Mara. Mara: Thanks for having me. Eric: So, this is an interesting podcast, Alex. Alex: Please.
And we’re delighted to welcome back Ken Covinsky , professor of medicine in the UCSF Division of Geriatrics, and frequent guest and co host of this podcast. So it is my experience that I can have conversations about end of life that none of you can have because I walk in the room and you do not have that trust.
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