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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. Thanks for having me.
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.
If they have not received intentional education about palliative care and the right clinical relationships within the ICU have not been developed, some ICU providers may view palliative care as antithetical to the work they are so rigorously and intentionally performing, emphasized a 2022 study co-authored by Ouchi.
Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. And I think that is among the reasons that we’re seeing major foundation after major foundation pull away from funding serious illness care, Canby is pulling away, the Moore Foundation has exited entirely.
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?
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. So for seven years, that person had been treated in accordance with that plan of care. Welcome back, Rebecca.
Hospitals Nurses working in the hospital environment directly oversee and administer patientcare plans. Typically, nurses spend time with and balance the care of several patients simultaneously. Geriatric A nurse who specializes in geriatriccare may be in the hospital setting or in a nursing home.
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 Geriatriccare: Geriatric-focused programs with good outcomes, dedicated space, and leadership by nurse experts.
That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition.
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. Have we figured out, does primary palliative care even work?
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. I think older adults greater than 65 using facilitated, I think advanced care planning versus usual care.
Alex 00:15 We are delighted to welcome back Louise Aronson, who’s a geriatrician and author in the UCSF division of Geriatrics. Eric 12:10 One theme that came out of that, just looking at the responses to your article, was there’s more to goals of care discussions than code status. Her most recent book is Elderhood.
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.
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. I am an acute care and adult and geriatric certified nurse practitioner. Andrews: That loss leader strategy, and the right level of care at the right time.
So take a listen and if you are interested in learning more, check out these wonderful links: Harvey’s latest book is called, Dignity in Care: The Human Side of Medicine Intensive Caring: Reminding Patients They Matter Michael J. Scientific American Letter to the Editor: Response to Downar et al.
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.
Accreditation In support of improving patientcare, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The culture, depending on what teams are involved, the complexity of the patientcare, whether we sometimes work with teams who want us to be co-facilitating every meeting with patient and family and others who say, “You go have the conversation, let us know how it goes.”
Potential that care received, though potentially burdensome, was in fact aligned with goals, and might represent goal concordant care. Potential that documenting advance directives without a robust conversation about prognosis might have led to these findings. Jennifer 17:26 Documentation of end of life preferences.
We want to do meaningful work and so we want to know that the conversations we have impact patientcare. So one that the primary outcome was supposed to be documentation, which it improved documentation, it wasn’t powered to actually look at any utilization or hard outcomes. And it’s been hard to do that.
But you know, we’re told if, if we say we’re increasing it for pain and we document that and then send it back to the methadone clinic, the methadone clinic won’t be able to increase, continue with that increased dose. We try to document that it’s for cravings or withdrawal symptoms or Sach.
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