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Palliative care may be gaining momentum across the health continuum in recent years, but several barriers exist preventing greater access and awareness, according to Dr. Kimberly Johnson, professor of medicine in the division of geriatrics at Duke Palliative Care and director of the Duke Center for Research to Advance Health Care Equity.
Summary Transcript Summary The comprehensive geriatric assessment is one of the cornerstones of geriatrics. But does the geriatric assessment do anything? Evidence has been mounting about the importance of the geriatric assessment for older adults with cancer, the subject of today’s podcast. Precision medicine?
Katz Professor and chair of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai. We definitely need to invest more research dollars into understanding what the impacts are of different financial players and how that affects outcomes,” Hunt told Hospice News. Morrison is also the Ellen and Howard C.
We also have a home-based primary care practice called Geriatric Solutions. Geriatric Solutions was about being able to be that patients primary care provider when they were too ill to go see one. The future is always grounded in making sure were focused on what the patient needs. That is the future.
Summary Transcript Summary What does the future hold for geriatrics? Historically, answers generally lamented the ever increasing need for geriatrics without a corresponding growth in the number of specialists in the field. On today’s podcast, we are going to do a deep dive on the future of geriatrics with three amazing guests.
Screening for addressing hearing loss should be an integral part of what we do in geriatrics and palliative care, but it often is either a passing thought or completely ignored. On today’s podcast, we talk to Nick Reed and Meg Wallhagen about hearing loss in geriatrics and palliative care. How to screen for hearing loss.
Mariah 03:51 I like the SAMHSA definition as sort of a guiding definition for it, and I’m happy to read it. Well, being a pretty comprehensive definition. Kate 11:33 Yeah, I mean, definitely more indirect pathways than direct. Eric 04:19 Yeah. So there’s an event or a series of events. Everything may not be.
Physicians in training need greater exposure to geriatric training in order to better grasp the needs of older patients, including during transitions to hospice, according to Dr. Julia Lowenthal, a geriatrician from Brigham and Women’s Hospital.
Well, so there is a debate in the field as to the definition of Alzheimer’s disease. Amyloid alone is enough of a definition of Alzheimer’s. So in someone who’s cognitively healthy, having the presence of amyloid would be enough for the definition of Alzheimer’s disease. So the new criteria came out.
Alex 01:27 We’re delighted to welcome back Tim F a rrell, who’s a geriatrician, associate chief for Age Friendly care at the University of Utah and chair of the American Geriatric Society Ethics Committee. All right, and finally we have Yael Zweig, who is a geriatric nurse practitioner at NYU. Tim, welcome back to GeriPal.
Though social determinants can take time and resources to build into palliative care programs, they come with a strong return on investment, according to Dr. Yaquta Patni, wound care and geriatric care physician at Innovative Geriatrics. The most important ones that we see are definitely [related to] transportation.
The trend points to ways that patients might receive palliative services through new avenues, such as geriatrics, primary care or home health care. A range of medical specialties are incorporating palliative care principles into their care models.
Freeland specializes in geriatrics, advance care planning and home-based primary care. Medicare Advantage beneficiary demographics have been changing in a positive direction in terms of reducing disparities among underserved populations, Freeland said.
Unfortunately, the lack of definition for the palliative care component led to a consistency issue across the demonstration, according to Mollie Gurian, vice president of Home-Based and HCBS Policy at LeadingAge.
There was definitely this idea in nephrology of what we called healthy start dialysis, which is this idea that we should start dialysis before someone develops really florid uremic symptoms. There was definitely a practice shift towards starting dialysis at higher levels of EGFR and with less severe symptoms.
Alex: And we’re delighted to welcome back Sharon Brangman, who is a SUNY Distinguished Service professor and chair of the Department of Geriatrics and director of the Center of Excellence for Alzheimer’s Disease. The field of geriatrics has been, I would say, somewhat negative on these drugs. Nate, is it you? Jason: Yeah.
I think there is definitely a growing interest among rehab professionals to learn more about palliative care and how to bring that to the therapies they’re doing and conversations they’re having with families and patients,” Flint said.
Alex: We are delighted to welcome Ramona Rhodes, who is a geriatrician and palliative care doctor, and member of the Board of Directors for the American Geriatric Society. Alex: And speaking of the American Geriatric Society, we are delighted to welcome Nancy Lundebjerg. Welcome to the GeriPal Podcast, Ramona. Ramona: Thank you.
Alex: Today we are delighted to welcome Chrissy Kistler, who is a geriatrician researcher in the Department of Family Medicine and Vision of Geriatrics at the University of North Carolina, Chapel Hill. Scott: The listeners are probably well aware that urinary incontinence is one of the kind of classic geriatric syndrome.
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. I think there is definitely a place, especially physical. What is the nature of suffering?
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?
Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach , and Beth Griffiths, primary care internist at UCSF and coach. Led the American Geriatric Society. Eric: Let me go to the definition real quick.
Younger physicians are definitely more open [to it].” 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 life care.
Summary Transcript Summary There is a growing push to change how we define Alzheimer’s disease from what was historically a clinically defined syndrome to a newer biological definition based on the presence of positive amyloid biomarkers. Again, those are for lay public definitions. That’s a definition.
We’re also delight to welcome Carla Perissinotto, who is a geriatrician palliative care doc at UCSF in the division of geriatrics. I moved to Baltimore in 2015 and did clinical fellowship in geriatrics. Ashwin, can you give us a broad overview of how you think about social isolation and loneliness as far as definitions?
That idea or that definition. So I think understanding the definition that the person in front of us has in relation to the word that they’re using is a really good jumping point, because we make a lot of assumptions in medicine and even in palliative care, hopefully trying to be more informed around our communication.
David: People with these illnesses suffer from persistent symptoms, poor quality of life, depression, anxiety, despite all the great things we do and all our colleagues in those specialties and in primary care and geriatrics. And I guess, I’d love to tell you what we definitely learned from that. I’ll say it.
J Am Geriatr Soc. Donovan Maust is a geriatric psychiatrist and health services researcher at the University of Michigan. But definitely gabapentin is one of those drugs that just has all of these off-label uses associated with it. Donovan No, we definitely don’t sing. Eric: And Alex, who do we have with us today?
That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. Ann: I definitely do. Sarguni: Yeah, definitely. There are definitely assessments we can do, but I’m not sure if there’s any predictive ones. Sweet Caroline. Eric: And why did you choose Sweet Caroline?
The definition of capacity in ethics and medicine, law. So I was thinking about the fast stages of dementia and could definitely imagine folks who are at a six level who are incontinent, who would say that’s not a quality of life that is tolerable to me. Thaddeus 14:50 I don’t think that’s right. And for that person.
She’s Professor and Vice Chair for Research at the Mount Sinai School of Medicine, Department of Geriatrics and Palliative Medicine. Alex: We’re delighted to welcome back to the GeriPal podcast, Krista Harrison, who is a Health Policy Researcher, an Associate Professor of Medicine, UCSF Division of Geriatrics.
If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. Nathan: Yeah.
We talk on this podcast about potential uses of AI in geriatrics and palliative care with natural language processing guru Charlotta Lindvall from DFCI, bioethicists and internist Matt DeCamp from University of Colorado, and prognosis wizard Sei Lee from UCSF. Sei Lee is Professor of Medicine at UCSF in the division of geriatrics.
I’d hazard that maybe half the patients I care for at the intersection of geriatrics and palliative care fall in the gray zone. And one quibble with that of course is that we think the definition of capacity is that it’s task and context specific. Eric: And to all of our listeners, thanks for joining us.
Eric: Martha – breaking the definition for palliative care, no longer an extra layer of support. laugher] Alex: I’m hopeful that there will be some people listening to this who are the future content creators in the geriatrics and palliative care space, and I look forward to what they have to offer.
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-life care. It was built in 1955, so it wasn’t designed for a geriatric population. And so the definition of family was broad.
Nikki Davis: I’m a nurse practitioner and have been working in geriatrics and palliative care for about 21 years now. It is something that I have been involved with in a past life, but I was definitely not where I would consider myself a subject matter expert.
Because I don’t think we think about that so much in palliative care, but we do in geriatrics. I’m definitely scared of when he’s going to be driving soon. As is the case for many issues in geriatrics: some of the time, not all the time. But I believe before we start, somebody has a song request for Alex.
How do you talk to them about these terms and these definitions? Naomi 14:50 I definitely think, and I love Jane, how you keep coming back to the moment, because that’s all we have. There are stories that are stuck in here that need definitely. Naomi, I’m going to turn to you. Thoughts on kind of where we are.
And in fact, as Alex mentioned in the intro, probably more than 20 years ago, Muriel Gillig asked me to help out with the geriatric modules at the Brigham women’s hospital primary care medicine sort of sessions. Nicole 06:04 In a way, it definitely does. And I know one of the topics I did was polypharmacy then. Is this tension?
And I learned, so you have this wonderful paper that just came out in JAGS, Journal of the American Geriatrics Society, titled Patients Living with Dementia Have Worse Outcomes When Undergoing High-Risk Procedures. So we followed Gretchen Schwarze’s definition, which was 1% or higher inpatient mortality was considered high-risk.
Does every institution need to get a community advisory board to tailor their rural tele-palliative care initiative (or geriatrics intervention) to the local communities served? Community leaders, and definitely faith community leaders. And so we’ve thought about this and goal concordant care definitely was the top.
Alex: Today, we are delighted to welcome James Deardorff, who is a geriatrician and a T-32 research fellow in UCSF’s Division of Geriatrics. He’s a Geriatrician Palliative Care Clinician Researcher, also in the UCSF Division of Geriatrics. which is kind of the typical definition of osteoporosis at that time.
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. . But definitely always had the bug to be the one to jump into the family meetings in the ICU, lead them. Kate: Yeah.
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