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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. Tim, welcome back to GeriPal.
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. But when you’re asking someone to make a decision about code status, you’re asking them to make a decision that is in effect right now in the present, right?
Well, as a kick off to this year’s first in-person State of the Science plenary, held in conjunction with the closing Saturday session of the AAHPM/HPNA Annual Assembly, 3 randomized clinical trials were presented. And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day.
And now ICU care has flourished, and we can keep people alive in the sense that their heart is beating and we can sustain their ventilation and circulation. For example, I had another patient in the ICU who she was on a ventilator. They didn’t come up in geriatrics very much. And we see that too in geriatrics.
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?
And for a few reasons, which I’m sure we’ll get into, I think it’s probably most effective upstream of the acute care setting, more in the nursing home setting or for patients who are not presenting in the hospital or emergency department setting. Eric: And thank you to all of our listeners for your continued support.
I felt like I was always told to present people with a buffet of options and, really, without guidance, ask them to choose, which is, it would always make me feel sick to my stomach. I think one of the residents you asked how would they broach a subject, and he said wording like, “Unfortunately, he still needs a ventilator.”
I think one of the challenges, especially about liver, is it doesn’t have a dialysis, it doesn’t have an ecMo, it doesn’t have a ventilator. Sarah 24:24 See, I usually always present it as these are things we should think of. Sarah 24:19 Well, I don’t know. Amy 24:21 For me, I always.
So whether or not somebody wants to be on CPR or ventilator, that sort of thing. The post Black/African American Caregivers of Older Adults Living with Dementia: Fayron Epps and Karen Moss appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional. It was great.
I developed bilateral pneumonia and was hospitalized but thankfully not put on a ventilator. Poison center nurses usually have at least two years of experience working in an ICU or an Emergency Department, but nurses in other specialties such as pediatric, geriatric, or transplant nursing can successfully make the transition into toxicology.
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. Excited to be here.
Right, my answer that brings us a little bit closer to the present than my childhood. So the kind of technological bind we’re talking about that first became recognized in the sixties or so with ventilators, the kinds of technologies that we have to sustain different kinds of bodily function. They don’t need a heart.
Not one elderly person died on a ventilator. But so many palliative care providers … and I had been in a presentation with Ira Byock about this, who agreed that palliative care folk, it’s like, “Everybody’s good. Pretty tough. Pretty … Just all things, right? Just really powerful. We’re all good.”
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