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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.
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. And when I think about advance care planning too, it all goes back to like meaning making, like who is this person? Welcome back, Rebecca. Who are they? Rebecca: Yeah.
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. There’s end of lifecare needs.
And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. And then they had to be receiving 48 hours of continuous mechanical ventilation at a minimum and be an adult. On the admission, are you telling them, “Think about withdrawal and life-sustaining treatments?”
You said something about your research in this area this morning pertaining to views of that term, end of life or end-of-lifecare. So the disconnect there potentially with healthcare providers is when we talk about end of life and end-of-life planning, we’re thinking about the before death stuff.
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. Eric 19:31 So it was interventions like feeding tubes, mechanical ventilation, dialysis at the very end of life. Danny 00:52 Thank you very much.
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