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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

ICU care was pretty rudimentary. 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. Almost all deaths in the ICU now are due to withdrawal of care or withholding of care. And that helps us get to the decision.

Document 196
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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

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!

Document 267
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Advance Care Planning Discussion: Susan Hickman, Sean Morrison, Rebecca Sudore, and Bob Arnold

GeriPal

Alex: And we have returning, Bob Arnold, who is a palliative care doctor at the University of Pittsburgh. 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. Susan: Thanks so much, Alex. Welcome back, Bob.

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Aging and the ICU: Podcast with Lauren Ferrante and Julien Cobert

GeriPal

And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation. That will be the last one in his life. Don’t ask anybody. Eric: Yeah. Alex: Yeah.

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What Lessons Have We Learned from the First COVID Surges? Jim Wright & Darrell Owens

GeriPal

Imagine that you are the medical director of a large (>150 bed) nursing home. Two-thirds of the patients in the home now have COVID-19. The other physicians who previously saw patients in the nursing home are no longer coming to your facility because you have COVID positive patients. Summary Transcript Summary.