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Deprescribing at the End of Life: Jennifer Tjia, Jon Furuno, Simon Mooijaart

GeriPal - A Geriatrics and Palliative Medicine Podcast

Release Date: 02/26/2026

LATE vs Alzheimer’s: Biomarkers, Mixed Dementia, and Clinical Realities with Nate Chin & Sterling Johnson

GeriPal - A Geriatrics and Palliative Medicine Podcast

Up until just a couple years ago, an 85-year-old patient presenting with gradual, amnestic memory loss was almost automatically presumed to have Alzheimer’s disease. However, new biomakers and the recognition of conditions like Limbic-predominant age-related TDP-43 encephalopathy (LATE) are reshaping our understanding of cognitive decline in older adults. It’s looking more clear that pure Alzheimers dementia is rare in older adults, and co-occurring pathologies that may include Alzheimer's, LATE, Lewy Body, and vascular neuropatholigies, are the rule rather than the exception. In...

Video-Enhanced Advance Care Planning: Joshua Lakin and Kei Ouchi

GeriPal - A Geriatrics and Palliative Medicine Podcast

Can simple, evidence-based video decision aids—paired with structured clinician training—improve Advance Care Planning (ACP) documentation and goal-concordant care? That’s the question we pose in this week's podcast with Dr. Joshua Lakin and Dr. Kei Ouchi. We break down the methodologies behind two major clinical trials in which they were involved that implemented this video-enhanced approach. The f was a multicenter, parallel randomized trial of 598 seriously ill older adults in emergency departments (EDs). It tested whether watching a 5-minute video and having a short, 10-minute...

Longevity Treatments - Snake Oil or Breakthrough? John Newman & Mahtab Jafari

GeriPal - A Geriatrics and Palliative Medicine Podcast

The longevity industry is booming. Influencers are promoting this and that as promoting healthy aging, longevity, and healthspan, and it’s hard for us, much less our patients, to make sense of it. To be sure, we should always start by recommending exercise, nutritious foods, good sleep habits, and meaningful social interaction. We wanted to go beyond that to talk about the promise and potential and risks/harms of “biohacks.” Today we talk with Mahtab Jafari, PharmD, and John Newman, MD, PhD, and to discuss: How we clinicians should think about this movement, knowing many of...

Who Should Deliver Palliative Care in Liver Disease? Chris Woodrell, Manisha Verma, Marie Bakitas

GeriPal - A Geriatrics and Palliative Medicine Podcast

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training? That’s the question we take a deep dive into on this week's podcast by breaking down the We’ve invited three of the trial's authors, , , and , to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We’ll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative...

Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer

GeriPal - A Geriatrics and Palliative Medicine Podcast

Emergency Podcast! Our guests Sean Morrison, Ken Covinsky, and Stacy Fischer believe that you should care deeply about the proposed shakeup at the National Institutes of Health. Major at the would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes of Health (NIH), the subject of today’s podcast. You dear listeners should all care. You should care because you care for older adults, or you’re a researcher who studies palliative care, or you're a chaplain who visited with the family of...

How We Limit Non-beneficial Life Sustaining Treatments: Jason Batten, Liz Dzeng, Teva Brender

GeriPal - A Geriatrics and Palliative Medicine Podcast

Today’s podcast is a natural follow up to our podcasts on and .Today we talk about a new study about how clinicians , published in JAMA Network Open. Do they adhere to society guidelines, which allow as permissible approaches only shared decision-making and following institutional policy. Or do they take alternative approaches, like not offering interventions, not mentioning interventions, or simply stating a plan to limit interventions? Turns out doctors are using these alternative approaches frequently. Our guests are Jason Batten, Liz Dzeng, and Teva Brender, all clinicians, all of...

Elder Mistreatment Prevention and Solutions: Carrie Rubenstein, Julia Hiner, & Tony Rosen

GeriPal - A Geriatrics and Palliative Medicine Podcast

Today we revisit a topic we last discussed in a : elder mistreatment. Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment, including: Terminology: elder mistreatment vs. abuse and neglect The need to incorporate prevention and solutions into how we talk about mistreatment This is not rocket science. Studying elder mistreatment is much harder than rocket science. Highlighting the reasons they focus on elder mistreatment, including inspiring words for...

CCRCs, ALFs, and Private Equity: John Burton, Bill Applegate, & Melissa Aldridge

GeriPal - A Geriatrics and Palliative Medicine Podcast

Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid. You can read about John’s early experiences in his JAGS commentary titled, The tone is bleak. John’s experience since Covid, as you’ll hear, is very positive. Many of the concerns he raised about isolation have been addressed. Second, we hear from Bill Applegate,...

Search for Geriatrician Identity: Mary Tinetti, Helen Fernandez, Jerry Gurwitz, Ken Covinsky

GeriPal - A Geriatrics and Palliative Medicine Podcast

Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the . Today’s conversation is prompted by multiple articles in JAGS: (1) an article with a title the same as this podcast; (2) an article by Helen Fernandez on “”, a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, “?” Of note, Mary’s article is a follow up to her 2017 in which she wrote: Those outside the field have difficulty understanding what geriatrics is and...

The Interior Experience of Prescribing Medical Aid in Dying: Carly Zapata and Dani Chammas

GeriPal - A Geriatrics and Palliative Medicine Podcast

I had the privilege of learning from fellow Lisa Harris about a term she termed, “.” As an ob/gyn and abortion provider, Lisa found the debate around the legality of abortion so polarizing that it created a false dichotomy: you’re either for or against. Any talk about misgivings, uncertainty, ambiguity, or ambivalence was silenced. Talking about these issues in the face of polarization was deemed dangerous and undermining to one side or another. “How could you?” For Lisa’s work in finding common ground and embracing nuance she was awarded the for forging...

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Philippe Pinel remarked in 1800 that “It is an art of no little importance to administer medicines properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them.” This insight remains profoundly relevant today, especially in hospice care, where inappropriate prescribing is a common issue. Studies show that 20%–70% of hospice patients receive at least one unnecessary medication near the end of life, including drugs like antihypertensives, statins, and vitamins.

In this episode of the GeriPal Podcast, we tackle the pressing topic of deprescribing at the end of life with expert guests Jennifer Tjia, Jon Furuno, and Simon Mooijaart. The conversation focuses on identifying medications that should almost always be discontinued—such as statins, osteoporosis meds, finasteride, and vitamins, which offer minimal benefit for patients with limited life expectancy. We also delve into more nuanced cases, such as antithrombotics, which present complex decisions that challenge clinicians, particularly when prognosis spans the many weeks to months range.

Finally, we explore practical strategies for engaging patients and families in deprescribing conversations. Our guests highlight tools such as the FRAME mnemonic (Focus on the goals of care, Review current medications, Assess each medication’s risk/benefit, Minimize the medication burden, and Evaluate regularly) and the Goal Concurrent Prescribing tool, which helps ensure medication decisions align with patients’ values and end-of-life priorities.

By: Eric Widera

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