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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.
You know, I think the key thing is that, yes, things are definitely changing back then. A lot of the principles that are talked about in core topics in substance use health, I definitely do extend. And so, you know, a sprinkle of humanity with some of those concepts definitely in combination are vital. Naheed 16:20 Yeah.
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.
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. They’ve all been laid out for you. Anne: Right. Alex: That one’s easy.
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.
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. Eric: Yeah.
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.
end of life care and advance care planning) to more geriatrics focused (e.g. Alex: And we’re also delighted to welcome back to the GeriPal podcast Kenny Lam, who’s assistant professor of medicine at UCSF in the Division of Geriatrics. It’s what happens in lots of different fields, including geriatrics.
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.
How definitions bind us, for example the division between chronic pain and palliative pain in much of the US. Somehow we were not very limited by definitions. Definitions can be shackles. Raj: We are not limited by definitions because we started our first non non-government organization. We create definitions.
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?
So, it’s definitely possible in sort of that oldest old category that there may be what we call silent aspiration, where someone aspirates, and then they don’t cough or clear their throat, so you actually wouldn’t even know that they’re aspirating. Raele: Yep, they definitely can be. Raele: Yes, definitely.
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.
Emily 06:11 Yeah, we definitely have a pill for every ill. Connie 32:18 Yeah, I think there’s definitely a need for a variety of different approaches. The stopping the cancer screening doesn’t have that same sort of momentum. I wonder if our guests feel that that’s maybe sort of an underlying issue here.
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?
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.
And then I did a geriatric orthopedic fellowship and that was really an exciting opportunity to help hip fracture patients, but then someone knocked on our door. Eric: What’s a geriatric orthopedic fellowship? So I got to help create one of the first geriatric orthopedic fellowships. Eric: Oh, that’s fabulous.
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.
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?
Lastly, Soo Borson is a self-described primary care leaning geriatric psychiatrist, developer of the Mini-Cog, and co-leads the CDC-funded BOLD Center on Early Detection of Dementia. Alex 00:09 We are delighted to welcome S oo Borson, who is a primary care oriented geriatric psychiatrist. Who do we have with us today?
Julie: I definitely feel like that because unfortunately, now I’m… And this is what I’m working on now is it’s really hard not to get focused on numbers and views and if someone’s going to like it, and now I have a book that I’m trying to sell, which I hate that feeling- Eric: You’ve got a brand.
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.
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.
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.
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