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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. This is Eric Widera.
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. Ideally, there’ll be a place in the chart that actually captures the name of that person and their contact information. Welcome back, Rebecca. Rebecca: Yeah.
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.
The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients. Eric: Initially it started with living wills back in the early-1970s development of durable-powered attorneys for healthcare.
You’re getting them with a little teeny slice of their information and you’re just trying to build some willingness for them to hear more. In that, again this is GeriPal Podcast, geriatrics falls into the same boat. There are 86-year-olds living in a nursing home with frailty, who I say, “I’m a geriatrician.”
So maybe not where I’m worried that you have months to a year to live, but I’m worried that you’re not going to be able to function as well, that you’re going to need someone to live with you, that you’ll need help going to the bathroom. Those kinds of things. There’s no decision.” Eric: Yeah.
At one end of the spectrum you can provide decision makers with information that doesn’t work very well in most contexts. We didn’t make them do anything with that information, just document it. Eric 38:32 I just want to know what do we do with this information? Alex 06:40 Legalese, the Ayn Rand version and more.
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