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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.
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. I don’t need a checkbox form, I don’t need to know about CPR or mechanical ventilation. Welcome back, Rebecca. Rebecca: Thanks for having us. Who are they?
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.
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. We have our socialworkers and our psychologists and we know how to manage these symptoms.
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. . You’re not hiring a bunch of socialworkers or nurses or docs to do it. Summary Transcript Summary.
Their oxygenation, while important, whether or not we can take them off the ventilator, probably has nothing to do with the big picture, oh, and they’re dying of metastatic pancreatic cancer. ” Don: It was part of the palliative care fellowship, a study of linguistics and communication.
It used to also be a socialworker and myself who would actually go to clinic and spend some time up there. Said socialworker has left since then, so it’s now just me. Eric 06:20 Your team look like, is it just you from the palliative care perspective? Sarah 06:23 It’s just me.
But luckily, Anne Kelly, our socialworker, was in the room with me and said the magic thing that just was the right thing to say. And yet, when the reality of breathing difficulties, BIPAP, the talks of tracheostomy and ventilators set in, what had seemed so clear on that piece of paper, no longer seemed so clear.
So whether or not somebody wants to be on CPR or ventilator, that sort of thing. ” Or for a socialworker, “Where are we going to discharge them to?” But the priority for these individuals, a lot of focus, and I totally get it, is on those services and the celebration of life afterwards.
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