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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.
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. For example, I had another patient in the ICU who she was on a ventilator. ICU care was pretty rudimentary.
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. Who are they?
We all, when bombarded with information have to take certain elements of a decision and focus on those; and in the ICU, you can imagine, we’re bombarded with information a lot. And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. Eric: Okay.
To me, that feels hard because I guess my inclination is that I want communication to be fixable, and there’s so much medical information and there’s a lot of reasons for families to feel like they’re struggling to understand. What was it, 5%? Eric: 2% of the time. Alex: 2% of the time.
And I have gone through my not-so-long career, but it’s coming up on nine years now, seeing the way that we have talked about CPR in such problematic ways, in ways that really do not enable true informed consent. And I wonder, because I read that need part a lot in this article. And I think a lot of that leads to extreme moral distress.
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. . They need, they need some, a little bit of information and probably a little more than that, what we like to call an edge.
I’d be willing to take some time on a mechanical ventilation machine to live longer.” And so the idea that patients are walking around with these on their shoulder like, “Hey, I got the mechanical ventilation preference, just want to make sure.” ” Because I’m like, “Yeah, to what end?
So I do think it’s useful to have that additional information. I can on one hand count the patients I’ve cared for who didn’t want mechanical ventilation. We do have the information of both our emergent call center and our electronic methods to access those forms. Do you find that helpful, that section?
As a provider, as somebody who has to constantly look whether or not somebody’s boosted and when is the next boost, our EHRs are disjointed, fragmented, doesn’t give us the information we need. Govind Persad and Emily Largent appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional.
It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. And so I was driven by the fact that I needed more information, and so it sort of became my clinical focus as well as I dabble in the research. We have both inpatient and outpatient at IU.
At that time, I formed a relationship with the center director and about 18 months later, she helped me form a plan to become a Registered Nurse and work my way into my position at NCPC as a Specialist in Poison Information (SPI). I developed bilateral pneumonia and was hospitalized but thankfully not put on a ventilator.
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. It was information about our ACP facilitator. Eric 19:31 So it was interventions like feeding tubes, mechanical ventilation, dialysis at the very end of life.
So legally dead in California, family moved to New Jersey, where she was kind of alive despite having a death certificate for another four years, and then died four years later after being actually home on a ventilator for a while, too, we talked more about that with the Bob Truog podcast. They don’t need a heart. Winston 14:17 Right.
Alex: We are delighted to welcome back two very special guests who were with us early in the COVID pandemic, and really shown a light on what was happening for the rest of us who could see this giant wave coming, and were just thirsty for information and experiences from those people who were experiencing it early. Pretty tough.
We did the Geriatric 5M approach to telemedicine with Lauren Mo. We sometimes take care of patients who are on home ventilators, so coming in for an office visit is not practically feasible. Brooke: I feel like you’re getting better year after year, so good. Alex: Hope so. So that song was already taken so we can’t do it.
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