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Mayo has focused on geriatric care for 17 years, completing a residency in family practice at Bethesda St. Hospices need to have internal processes to ensure compliant care delivery practices, including having robust quality assurance reviews and ongoing documentation review processes, Mayo indicated. Joe’s Hospital in St.
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?
Providers need stronger supportive programs that help caregivers more effectively navigate the challenges of dementia care, said principal investigator of the study Dr. David Reuben, director of geriatric medicine and gerontology at the University of California, Los Angeles (UCLA) Health system.
So Daily Nurse spoke with Bei Wu, PhD, FGSA, FAAN (Honorary), Vice Dean for Research, Dean’s Professor in Global Health, New York University, Rory Meyers College of Nursing , and Xiang Qi, BSN, RN, PhD candidate at New York University, Rory Meyers College of Nursing about ChatGPT’s potential use in geriatric nursing education.
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.
This began a series of discussions that led to what Jain called a “David and Goliath document” that sketched out the vision for HealthRight and its potential differentiators from the for-profit giants in the space. As the prospect of the combination started to bloom, the SCAN term broached the idea in a letter to CareOregon leadership.
Missouri set a very high bar, explicit written documentation that applies to this specific circumstance, which the Cruzan’s eventually cleared. But legislation can change, clinical practice can change, but I think what we’ll talk about today is how we’re now opening the door to conversations rather than legal rules and documents.
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.
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.
Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Because we haven’t done our job to document the value of what we’re doing. And I use that as that documentation about what they want, recognizing that not everybody does that.
So, we have had to be thoughtful and innovative about how we’re going to actually ensure that we’re reaching those patients in the ICU with unmet palliative care needs,” said Dr. Laura Gelfman, MD, MPH, Deputy Director of Quality and Clinical Information, Department of Geriatrics and Palliative Medicine at Mount Sinai Health System.
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. And it has fairly well documented biases.
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 this actually happened just a few minutes away from where I was practicing geriatrics medicine as a part of my fellowship. Geriatrician?
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.
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 Bob also noted documenting it. Eric: So Susan, and would you say that a POLST is more of a care planning document rather than an advance care planning document?
I’d hazard that maybe half the patients I care for at the intersection of geriatrics and palliative care fall in the gray zone. They had it, the note then documents that they don’t have it. Emily’s expanded notion of consent is grounded in the concept of “relational autonomy.” Anne Rohlfing: I think that is a positive aspect.
J Am Geriatr Soc. 2017 The Illegal Marketing Practices by Pharma promoting ineffective: The Neurontin Legacy — Marketing through Misinformation and Manipulation NEJM 2009 Narrative review: the promotion of gabapentin: an analysis of internal industry documents. Cochrane Database of Systematic Reviews Review. Annals of IM.
I’m not going to have time to read 22 pages of this legacy document. They’re just a 20-page document because there’s so much detail in there that we as clinicians type, but it’s not first-person. But because I was such a clinician, I was like, okay, I know what my clinical work looks like.
Geriatric A nurse who specializes in geriatric care may be in the hospital setting or in a nursing home. In-home Nurses working in the in-home environment have similar responsibilities to the geriatric nurse. Their primary role is to care for the elderly when they can no longer care for themselves.
That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. How do you clearly articulate the value in what you deliver when we can’t even fully document it in our notes so that we can sit at tables and boardrooms and say, “Look, we’re more than just mobility training.
The Beers Criteria is one of the most frequently cited reference tools in geriatrics, detailing potentially inappropriate medications to prescribe to older people. We’re delighted to welcome Mike Steinman, who’s a geriatrician professor of medicine at UCSF in the division of geriatrics, prior guest on this podcast.
Organizations reapply for recognition every four years and submit documented evidence that staff has sustained and improved Magnet concepts, performance, and quality since its previous designation. “We Geriatric care: Geriatric-focused programs with good outcomes, dedicated space, and leadership by nurse experts.
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. . And so it’s within normal practice to have a reasoning and be accountable for it and document that.
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. Yep, for geriatrics? Are there other members of the team we should be involved? Alex: … pre-operative assessment?
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. Eric: And Alex, who do we have with us today? Welcome to the GeriPal podcast, James.
Nurses have worked in a variety of settings in telehealth—such as school nursing, critical care, emergency care, specialty care, and geriatrics, Arends says. Remember Documentation Just as you would if seeing a patient in person, nurses need to do documentation.
What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. Eric: 3,500 people.
As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” So it’s this tension that I constantly think about.
Alex: And we have Hillary Lum, who is a geriatrics and palliative care researcher at the University of Colorado. Hillary: And then I also see us measuring advance care planning documents on file in the health system so that that’s not where I want us to be. We have Sarah Nouri, who is a palliative care doc and researcher at UCSF.
Alex 00:15 We are delighted to welcome back Louise Aronson, who’s a geriatrician and author in the UCSF division of Geriatrics. There’s more to it that you should be documenting than DNR DNI, which seems like. Eric 00:13 And, Alex, who do we have with us today? Her most recent book is Elderhood. We need more.
Abhilash Desai, MD , geriatric psychiatrist, adjunct associate professor in the department of psychiatry at University of Washington School of Medicine, and poet! Alex: And we have Ab Desai, who’s a geriatric psychiatrist in Idaho. Eric: Don’t even have to document. Anne, welcome to the GeriPal podcast.
Why don’t people want to document serious illness conversations? I think this is actually bread and butter geriatrics. And then there’s this other time, and this gets to the geriatric patients, where you’re adapting to change and loss and then it’s a new normal that you’re trying to adapt to.
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? I think there was an increase in advanced care planning documentation, but the group that got the intervention had higher rates of potentially burdensome care.
And I told her I quote LaVera every year when I teach the geriatrics fellows, the palliative care fellows, I would love for you to tell the story that I quote because you experienced it. On the one hand people have said research is the meticulous documentation of the blatantly obvious, which is kind of LaVera’s point here.
And so I think of it as more like the patient who’s on document dialysis, who. The post Hastening Death by Stopping Eating and Drinking: Hope Wechkin, Thaddeus Pope, & Josh Briscoe appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional. For any MOC questions, please email moc@ucsf.edu.
You’ve had three documented conversations to “clarify code status.” And I think part of the problem is for many people who are doctors, and I’m not talking to our palliative care geriatric audience, there is a sense of what it is to be a doctor is to fix things, is to save lives. Alex: Thank you.
And if you look, who gets to define this, it’s pretty well documented. Then you have to actually look at the document and ask, did any one of these 36 people read the document from cover to cover? Then the question is, who gets to define these diseases? The who in the room who defines it is heavily industry biased.
So it can create a generativity or legacy document, that will be given to that individual so they can bequeath it to loved ones. The post Dignity at the End of Life: A Podcast with Harvey Chochinov appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional.
Alex: We are delighted to welcome back to the GeriPal podcast, Katie Fitzgerald Jones, who’s a nurse scientist at the New England Geriatric Research Education and Clinical Center, and a palliative and addiction nurse practitioner at the VA in Boston. It’s not well-documented. Who do we have with us today? Devon: Right.
I am an acute care and adult and geriatric certified nurse practitioner. Tina Taylor: I’m Tina Taylor, vice president of palliative care at Compassus. I am responsible for our national palliative care programs across the nation. We have to get it right.
And I document those differently in my notes, and we have a goals of care template within our EMR that then I’ll document if transplants off the table, these are their wishes, and so I sort of have a contingency plan, but at minimum, everybody, everybody needs a healthcare representative who knows the patient’s wishes.
What that looks like, to some degree, by having a conversation, by documenting wishes, we can potentially influence what that looks like and what that experience is for that person who is dying and then also for family members who are left behind. Alex: I was going to say Fayron, you can go second.
The post Influence of Hospital Culture on Intensity of Care: Liz Dzeng appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional. Eric: And with that, Alex, do you want to end us with a little bit more Proud Mary? This is such an honor to be able to talk to you guys about this paper.
He stopped in to request information and instead received an immediate call back from who would turn out to be the most formative person in his life, David Weissman, MD, the founding Director of the Geriatric and Palliative Medicine program at the medical college.
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