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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?
So just by the nature of prognosis there, and I think, you know, this, this is really where I think the, the value of an interdisciplinary team, which we do so well in geriatrics and palliative care, is important in thinking about approach to these patients because perspective. Ashwin 23:46 Yeah. And I love the structured approach.
If you develop dementia, odds are you will spend the last months to years of your life in a nursing home or assisted living facility. This study explored nursing home organizational factors and staff perceptions that are associated with the variation in care for residents with advanced dementia. Archives of Internal Medicine 2010.
Sue Britton was the first nurse hired on that palliative care unit. Alex 01:08 And we’re delighted to welcome Sue Britton, who was the first nurse in the very first palliative care unit in Quebec at the Royal Victoria Hospital in 1975. She started her career as a nurse and probably her heightened that worked against her.
In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. She had a respiratory arrest, and the nurse was really distraught.
Because, if anybody hasn’t seen it, you’ve got a great Twitter feed that gives tons of pearls on palliative care and a lot on communication. Speaking of pearls, should we move to Shunichi’s Twitter feed? Alex: Shunichi, your Twitter feed is like haiku. What motivated you to dive into this? We teach those.
Nikki Davis: I’m a nurse practitioner and have been working in geriatrics and palliative care for about 21 years now. I made my way through the ranks as a CNA, then a registered nurse, and then a nurse practitioner and now, I’m in a leadership position.
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. And the nurse can’t dose it, they have to individually dose it.
And they agreed on that and they talked to the people at the hospital, the surgeons and the nurses. And the nurses says you’re making the right decision. You’ll have a feeding tube. Yep, for geriatrics? She wasn’t communicating, she couldn’t remember anybody’s name, nothing. Samir: Yeah.
Kevin’s study looks at a period of time in the COVID pandemic when a large multistate nursing home provider created a “nonessential medication on hold” (NEMOH) policy in order to conserve critical nursing resources and PPE, and to limit exposure risk for residents by reducing unnecessary contact. nursing homes. Kevin: Yeah.
The nurses say we can’t touch them anywhere. And you may have missed the turnoff between delirium and pain, or your nurses may have. And you want to go over it, the DAG with your colleagues, with the nurses, with the nurse manager; you want everybody to feel comfortable, and let them know what the side effects are.
For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!
When I’m on nursing home call, the most common page I receive is for a blood sugar value. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice? Summary Transcript Summary Diabetes is common.
We welcome all professions, including but not limited to physicians, chaplains, social workers, nurses, nurse practitioners, case managers, administrators, and pharmacists. Could it be the bedside nurse? It meets in-person, once a month, over nine sessions. For inquiries or to apply, please contact gayle.kojimoto@ucsf.edu.
But the team that I got to work with, physician, nurse, myself, child life, we work so well together that we finish each other’s sentences. But working long enough with my physician, nurse, pharmacy, colleagues, child life, I’m going to get to know them well enough to know where they’re going next. Barbara: Yeah.
Like, just even having that and normalizing it, and, like, after 13 years of training or 15 or whatever, chaplains, nurses, social workers, patient care assistants, everyone is working in these systems that are not built to take care of them. This whole idea that our worth is not equal to our productivity. And I think that’s just, like.
However if you want to take a deeper dive, check out his website “ The Ink Vessel ” or his amazing twitter feed which has a lot of his work in it. And a lot of that work and effort has now been shifted onto a family who’s having to be doctors and nurses around the clock. Transcript. Eric: Welcome to the GeriPal podcast.
We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. I think it’s around one in 12 nursing home patients But it’s a lot.
We’ve invited: Julie McFadden (aka Hospice Nurse Julie ): Julie is a social media superstar, with 1.5 And then Hospice Nurse Julie. Julie McFadden goes by Hospice Nurse Julie. I’m going to start off with Nurse Julie, Hospice Nurse Julie, I think that’s your full title on TikTok. That was a lot of fun.
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. He, his Twitter feed though is brilliant. Eric: Yeah.
Accreditation In support of improving patient care, 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. Anne: Right.
Then I started reading about this and a British nurse started preaching palliative care all over India. So, she was in a pathetic stage and she had no way of coming and seeing the mother because she had to feed the children from her earnings. Came across her, got some training in Oxford, several people joined me. Raj: Thank you.
I remember as a fellow, I would come in and our nurse practitioner on our hospice team, I would say the word narcotics, and f or half an hour, she would just lay into me. They often have behavioral issues stemming from their disorder, their life circumstances, all sort of feeding into each other. We just unlearn what we have learned.
And I ran into a nurse in the stairwell eating, because we don’t have any space to eat and she’s eating. And then the infusion nurse comes and she walks a few steps and she talks about what it was like to hear that prognosis. Or the cases where someone actually said, “I never want a feeding tube.”
She’s a palliative care nurse educator and a writer, and she’s joining us from the great state of Hawaii. Redwing: So I grew up in a pretty intellectual family, but my brother and sister were six and 10 years older than me, and they were always feeding me literature and poetry. Alex: This is Alex Smith. Redwing: Thank you.
I actually went to planned parenthood of Rhode island, and as a practicing oncologist, sat with folks, some of who had just graduated high school, others who were nurse practitioners, and they started from the very, very basics of pelvic anatomy. These are oncology nurse practitioners. Who asks about sexual health and intimacy?
On the other hand, when I hear of workarounds to assist patients to die, or even euthanize them, I worry that we’ve gone back to a time when the doctor or nurse knows best – and should be morally permitted to do whatever they think is right, according to their conscience. Do we really trust all doctors and nurses so far?
But I do think that there’s a tension here, which is that in order for these algorithms to work, you need to feed them a ton of data. And then you think, well, what kind of data are you feeding it? Jenny 27:44 I mean, it’s that, yes, it is better than a coin flip. That’s what these algorithms need.
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