GeriPal - A Geriatrics and Palliative Care Podcast

A geriatrics and palliative care podcast for every health care professional. We invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. You'll laugh, learn and maybe sing along. Hosted by Eric Widera and Alex Smith. CME available!

Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky 04/17/2025

Loss of DEI Hurts Everyone: Farah Stockman, Ali Thomas, Ken Covinsky I read Farah Stockman’s article in the NYT on , and thought, “Yes, and ‘everyone’ includes harm to our healthcare workforce, our patients, and their families.” So we’re delighted that Farah Stockman, pulitzer prize winning journalist, author of , and editorial board member at the New York TImes joins us to set the bigger picture for this discussion. Farah provides clear examples from the Biden administration, in which having the most diverse cabinet in history was critical to building bridges, empathy, and inspiring others to feel included. We are also pleased to welcome Ali Thomas, a hospitalist, member of the Baha'i Faith, leader of anti-racism efforts in the Pacific Northwest, and founder of the . Ali talks about the history of affirmative action, which started as a , the importance of diversity in the healthcare , the history of allyship and cross cultural collaboration, and his own efforts to provide opportunity and support for historically oppressed groups in his own community to obtain healthcare careers. And Ken Covinsky, avid baseball fanatic, joins us and notes that the day we record (April 15) is . Many may be familiar with the story of Jackie Robinson breaking the color barrier in major league baseball in 1947, but may not be aware of the tremendous adversity Jackie Robinson faced, and persistence he displayed, off the field. We address many things, including: The movement in Corporate America and institutes of higher education to implement DEI programming in the wake of George Floyd The general agreement in America of the value of diversity, and disagreement, unpopularity, and backlash about DEI as it was implemented How the pursuit of diversity and excellence are not in tension, they are aligned and necessary for each other What we can do to build bridges across differences There was so much we hoped to talk about and didn’t get to, but I will link to now, including: Ali’s mom’s personal history with and study of , Farah’s mom’s pioneering work as a , and Ken’s perspectives on the importance of studying . What a Wonderful World could be sung in irony at this moment. I hope we all take it literally, with the hope this podcast ends with. -Alex Smith /episode/index/show/geripal/id/36188605

RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest 04/10/2025

RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. I emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. I can’t do the primary thing I’ve been trained to do: ABC, ABC, ABCs. Most emergency providers wanted to for seriously ill patients, but they didn’t have the knowledge, skills, or experience to do it. Today we focus on an , published in JAMA, that gave emergency clinicians basic palliative care knowledge, training, and skills. We talk with Corita Grudzen and Fernanda Bellolio about their cluster stepped wedge randomized . They got training in Vital Talk and ELNEC. They got a decision support tool that identified hospice patients or those who might benefit from a goals of care discussion. They got feedback. So did it matter? Hmmm….it depends. We are fortunate to have Tammie Quest, emergency and palliative trained and long a leader in this space, to help us unpack and contextualize these findings. Today we discuss: Why the study was for the primary (hospitalization) and all secondary outcome (e.g. hospice use). Why to emergency clinicians, this study was a wild because they had the skills they wanted/needed to feel like they could do the right thing (during the onset of Covid no less). Why this study was a success due to the sheer size (nearly 100,000 patients in about 30 EDs) of the study, and the fact that, as far as the investigators know, all study sites continue to employ the clinical decision support tool. What is a cluster stepped wedge randomized trial? Were they surprised by the negative findings? How do we situate this study in the context of other negative primary palliative care interventions, outside the ED? E.g. Yael Shenker’s , Randy Curtis’s , Lieve Van den Block’s negative study of . Why do so many (most, all??) primary palliative care interventions seem to fail, whereas specialized palliative care interventions have a relatively robust track record of success. Should we give up on primary palliative care? What’s next for primary palliative care interventions in the ED? And if your Basic Life Support training certification is due, you can practice the correct chest compression rate of 110 beats per minute to Another One Bites the Dust. -Alex Smith /episode/index/show/geripal/id/36075960

GeriPal Takeover! Nancy Lundebjerg and Annie Medina-Walpole 04/03/2025

Pragmatic Trial of ACP: Jennifer Wolff, Sydney Dy, Danny Scerpella, and Jasmine Santoyo-Olsson 03/27/2025

Pragmatic Trial of ACP: Jennifer Wolff, Sydney Dy, Danny Scerpella, and Jasmine Santoyo-Olsson A pragmatic trial evaluates the effectiveness of a treatment or intervention in “real-world” clinical practice. Outcomes are typically assessed from available records. Eligibility in pragmatic trials are often broad, and don’t have the exclusions of efficacy studies, which examine treatment effects under highly controlled conditions in highly select populations. Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying . We spend the last portion of the podcast discussing the surprising finding of the study. In the primary care practices that received the advance care planning intervention, rates of advance care planning were higher (about double). Shockingly, rates of potentially burdensome intervention (intubation, CPR, etc) were also higher in the advance care planning intervention group. What?!? Not a typo. We spend some time unpacking and contextualizing the potential reasons for this surprising finding, including: Disconnect between relatively low rates of (12% in intervention arm vs 7% control) and higher rates of potentially burdensome treatment among decedents (29% in intervention arm vs 21% control). Only 5% of intervention patients received the facilitator led component of the intervention (there were other components, facilitator-led was the most engaged component). Was there really a causal connection between the intervention, new advance directives, and higher rates of potentially burdensome interventions? Potential that care received, though potentially burdensome, was in fact aligned with goals, and might represent . Potential that documenting advance directives without a robust conversation about prognosis might have led to these findings. My goals will differ if I think I probably have 2 years to live vs 10 years. Comparison to a trial Yael Shenker discussed in our podcast on (also used the Respecting Choices intervention, outcome differed). Implications for the larger over the value of advance care planning, and additional research into advance care planning. As I say on the podcast, I’m sure would be delighted to point to these findings as evidence that advance care planning doesn’t work, and in fact may be harmful. And I got to sing in Spanish for the time. I hope my pronunciation is better than my , or ! -Alex Smith /episode/index/show/geripal/id/35879760

Hastening Death by Stopping Eating and Drinking: Hope Wechkin, Thaddeus Pope, & Josh Briscoe 03/20/2025

Hastening Death by Stopping Eating and Drinking: Hope Wechkin, Thaddeus Pope, & Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (), and multiple episodes about the ethical issues surrounding medical aid in dying (). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life? To delve into these questions, we spoke with Hope Wechkin, medical director of EvergreenHealth home hospice, who authored an article describing a process of (MCF) for patients who have expressed an interest in not wanting to live with advanced dementia. MCF, which Hope implemented for one of her hospice patients, serves as a middle way between the discomfort to the patient and caregivers of completely withholding food and fluid, and the current practice of comfort feeding only in which food and fluid are routinely offered to patients even in the absence of a symptomatic benefit. We were also joined by Thaddeus Pope, JD and Dr. Joshua Briscoe, to discuss the topic of voluntarily stopping eating and drinking as a potential bridge to access medications and their respective on the topic. We discussed what makes an illness “terminal”, what goes into assessing capacity for an action as simple as requesting something to drink, and whether the TV show Severance illuminates any of these answers. -Theo Slomoff, UCSF Palliative Care Fellow 2024-25 (guest host) Articles referenced in this discussion: by Hope Wechkin et al in JPSM by Thaddeus Pope and Lisa Brodoff in JAGS also in JAGS by Joshua Briscoe and Eric Widera Past GeriPal Podcast Episodes on MAID: MAID podcasts Past GeriPal Podcast Episode about VSED: /episode/index/show/geripal/id/35781165

The Roots of Palliative Care: Michael Kearney, Sue Britton, and Justin Sanders 03/13/2025

The Roots of Palliative Care: Michael Kearney, Sue Britton, and Justin Sanders As far as we’ve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? In today’s podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care. Sue Britton was the first nurse hired on that palliative care unit. on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry. Justin Sanders wants to be sure the newer generations of palliative care clinicians understand the early principles and problems that animated the founders of hospice and palliative care, including: Origins of the word “palliative” - it’s not what I thought! Yes, it means “to cloak,” but there’s more… Whole-person-care as a process distinct from the deterioration of the body The as the unit of care Our guests referenced many articles on this podcast, linked above and below. If you read just one, read ? by Kearney. I promise it’s short. 2 pages. Here’s a taste: …While there is an abusive and useless dimension to illness, pain and suffering which needs to be removed if at all possible, there is also potential in such experience…If we in palliative medicine fail to accept this view, a view which allows that there may also be a potential in the suffering of the dying process, if we sell out completely to the literalism of the medical model with its view that such suffering is only a problem, we will be in danger of following a pattern which could significantly limit our scope for development and lead to our becoming ’symptomatologists’, within just another specialty. And love that Jim Croce choice. What’s in a name? Enjoy! -Alex Smith Links Link to the , Michael Kearney as initial presenter, and registration for future events. No, you don’t need to be Canadian. Canadians are welcoming. In Palliative Medicine By Kearney Joe Wood’s book on Balfour Mount’s memoir paper on in JPSM and in Palliative Medicine , by David Clark Caring for Patients at the End of Life, by Michael Kearney and colleagues in JAMA Perspectives on Care at the Close of Life series Twycross on /episode/index/show/geripal/id/35663665

PC for People Experiencing Homelessness: Naheed Dosani 03/06/2025

PC for People Experiencing Homelessness: Naheed Dosani I was very proud to use the word “” on today’s podcast. See if you can pick out the moment. I say something like, “Palliative care for people experiencing homelessness is, in many ways, the apotheosis of great palliative care.” And I believe that to be true. When you think about the early concepts that shaped the field, you can see how palliative care for persons experiencing homelessness fits like a hand in a glove: total pain envisioned by Cicely Saunders, which even its s included social suffering like loneliness; or Balfour Mount, who coined the term “palliative care,” lamenting the , and the desperate need to create programs to reach more people experiencing suffering. Today we talk with Naheed Dosani, a palliative care physician at St. Michael’s Hospital in Toronto, and health justice activist. His story, which he shares on today’s podcast, is remarkable. Just out of fellowship, Naheed built a palliative care program for homeless persons called the Palliative Education and Care for the Homeless (PEACH) Program. This podcast is a complement to our prior podcast on with Margot Kushel. Today we discuss: What is the best terminology? Homeless? Homelessness? Houseless? Marginally housed? What makes palliative care for people experiencing homelessness challenging? What makes it rewarding? What is unique about the practice of palliative care for people experiencing homelessness? We discuss the principles of harm reduction, social determinants of health, and trauma informed care. Major overlap with substance use disorder issues, which we have covered recently (and frequently) on this podcast. How are the health systems designed or not designed to meet the needs of people experiencing homelessness? What are the equity issues at stake, and at risk of being cut, both in Canada and the US? Many more links below. And I had a blast playing Blinding Lights by that Toronto band The Weekend. Enjoy! -Alex End Well Talk Resources on the PEACH Program Program Review Paper – A recent publication in Longwoods Healthcare Quarterly reviewing the PEACH model. Promising Practice Recognition – PEACH was named a Promising Practice in equity-oriented palliative care as part of a national initiative funded by Health Canada, operated by Healthcare Excellence Canada & the Canadian Partnership Against Cancer. Toronto Star Feature CityNews Toronto Feature Psychosocial Interventions at PEACH In addition to medical care, PEACH also runs two key psychosocial interventions for our clients: PEACH Grief Circles – Structured spaces for workers in the homelessness sector to process grief. CBC covered this a few years ago, including a radio segment feature on CBC White Coat, Black Art (which you can access at the below link). PEACH Good Wishes Program – A program that provides meaningful gifts for unhoused individuals who are terminally ill. Kensington Hospice & 'Radical Love' Equity-Oriented Hospice Palliative Care Naheed Dosani also serves as the Medical Director of Kensington Hospice, Toronto’s largest hospice. There, he helps run an innovative program called 'Radical Love' Equity-Oriented Hospice Palliative Care, which provides low-threshold, low-barrier access to hospice care for structurally vulnerable individuals (e.g., those experiencing homelessness). The program also operates via a partnership with the PEACH Program. As a result of the 'Radical Love' program at Kensington Hospice: At any given time, Kensington Hospice has evolved from caring for structurally vulnerable individuals <2% of the time...to now serving structurally vulnerable people 40–50% of the time. Canadian Press Feature – A powerful and widely shared piece on our work. Promising Practice Recognition – Kensington Hospice’s Radical Love program was also recognized as a Promising Practice by Healthcare Excellence Canada & the Canadian Partnership Against Cancer. National Canadian Efforts in Equity-Oriented Palliative Care Canada is investing in equity-oriented palliative care through the Improving Equity in Access to Palliative Care (IEAPC) Collaborative. This is a multi-year funded initiative that supports 23 equity-oriented palliative care models for people experiencing homelessness and structural vulnerabilities across Canada. /episode/index/show/geripal/id/35549595

PC for Patients with Substance Use Disorder: Janet Ho, Sach Kale, Julie Childers 02/27/2025

PC for Patients with Substance Use Disorder: Janet Ho, Sach Kale, Julie Childers Much like , we plan to revisit certain high impact and dynamic topics frequently. Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. You can listen to our prior podcasts on substance use disorder , , , and . Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. We address: Why is caring for patients with this overlap so hard? Inspired by Dani Chammas’s paper in Annals of Internal Medicine titled, “” we talk about countertransference: start by asking yourself, “Why am I having difficulty? What is making this hard for me?” Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Why? How? What do they do? Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not). See Sach’s write up about setting up this clinic in . What is harm reduction and how can we implement it in practice? One key tenet of harm reduction we return to multiple times on this podcast: Accountability without termination (or, in more familiar language, without abandonment). When to consider bupenorphine vs methadone? Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness - should we/can we split up the once daily dosing to achieve better pain control? Who follows the patient once the cancer goes into remission? Who will prescribe the buprenorphine then? Or when it progresses - will hospice pay? And so much more: maybe not the oxycodone for breakthrough; when the IV dilaudid is the only thing that works; pill counts and urine drug tests; the 3 Ps approach (pain, pattern, prognosis); stimulant use disorder; a forthcoming section… Thanks to the many questions that came in on social media from listeners in advance of this podcast. We all have questions. We addressed as many of your listener questions as we could. We could have talked for 4 hours and will definitely revisit this issue! Sometimes . -Alex: /episode/index/show/geripal/id/35443525

Trauma-Informed Care: A Podcast with Mariah Robertson, Kate Duchowny, and Ashwin Kotwal 02/20/2025

Plenary Abstracts at AAHPM/HPNA: Yael Schenker, Na Ouyang, Marie Bakitas 02/13/2025

Plenary Abstracts at AAHPM/HPNA: Yael Schenker, Na Ouyang, Marie Bakitas In today’s podcast we were delighted to be joined by the presenters of the top scientific abstracts for the Annual Assembly of the American Academy of Hospice and Palliative Medicine () and the Hospice and Palliative Medicine Nurses Association (). Eric and I interviewed these presenters at the meeting on Thursday (before the pub crawl, thankfully). On Saturday, they formally presented their abstracts during the plenary session, followed by a wonderful question and answer session with Hillary Lum doing a terrific job in the role of moderator. Our three guests were Marie Bakitas, who conducted a trial of tele/video palliative care for Black and White inpatients with serious illness hospitalized in the rural south; Yael Shenker, for a trial of patient-directed vs. facilitated style advance care planning interventions; and, Na Ouyang, who studied the relationship between prognostic communication and prolonged grief among the parents of children who died from cancer. From just the abstracts we had so many questions. We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Marie’s tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Does every institution need to get a community advisory board to tailor their rural tele-palliative care initiative (or geriatrics intervention) to the local communities served? Who would/should be on that board? How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? Advance care planning has taken a beating. For the purposes of a thought exercise, no matter what you believe, let’s assume that there are clear important benefits. Based on the results of Yael’s study, should resources be allocated to resource intensive nurse facilitated sessions (), which had significantly better engagement, or to low resource intensive patient-facing materials (), which had significantly less engagement but still plenty of engagement (e.g. 75% vs 61% advance directive completion)? One interpretation of Na’s study is that clinicians can lean on the high levels of trust and high ratings of communication to engage with parents of children with cancer about prognosis. Another interpretation is that clinicians avoided telling the parents prognosis in order to bolster their ratings of trust and communication quality. Which is it? Bonus: he composed the song Sounds of Silence in a dark echoing bathroom about his concerns that people had stopped listening to each other in the 1960s (still resonates, right?). Garfunkel says Simon was writing about . Who’s got the right of it? Enjoy! -Alex Smith /episode/index/show/geripal/id/35264790

How to Make an Alzheimer's Diagnosis in Primary Care: A Podcast with Nathaniel Chin 02/06/2025

Telehealth vs In-Person Palliative Care: Guests Joseph Greer, Lynn Flint, Simone Rinaldi, and Vicki Jackson 01/30/2025

Deprescribing Super Special III: Constance Fung, Emily McDonald, Amy Linsky, and Michelle Odden 01/23/2025

Deprescribing Super Special III: Constance Fung, Emily McDonald, Amy Linsky, and Michelle Odden It’s another deprescribing super special on today's GeriPal Podcast, where we delve into the latest research on deprescribing medications prescribed to older adults. Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes. In our first segment, we discuss a study led by Constance Fung and her team, which investigated the . The study involved 188 middle-aged and older adults who had been using medications like lorazepam, alprazolam, clonazepam, temazepam, and zolpidem for insomnia. The results were impressive: 73% of participants in the masked tapering plus augmented CBTI group successfully discontinued their medication, compared to 59% in the open taper plus standard CBTI group. This significant difference highlights the potential of targeting placebo effect mechanisms to enhance deprescribing efforts. Next, we turn to Emily McDonald, the director of the , to discuss her . Patients received brochures detailing the risks of gabapentinoids, nonpharmacologic alternatives, and a proposed deprescribing regimen (see ). Additionally, clinicians participated in monthly educational sessions. The intervention group saw a deprescribing rate of 21.1%, compared to 9.9% in the usual care group. This study underscores the power of patient education in promoting safer medication use. In our third segment, we explore Amy Linsky’s . The intervention involved mailing medication-specific brochures to patients before their primary care appointments (click ). The results showed a modest but significant increase in deprescribing rates among the intervention group. This approach demonstrates the potential of simple, low-cost interventions to improve medication safety. Finally, we discuss Michelle Odden’s . The study included 12,644 residents and found that deprescribing was associated with less cognitive decline, particularly among those with dementia4. These findings and the two studies Michelle mentions in the podcast ( and ) suggest that carefully reducing medication use in older adults may help preserve cognitive function. However, the study adds more questions to that conclusion. Join us as we dive deeper into these studies and discuss the implications for clinical practice and patient care. Don’t miss this episode if you’re interested in the latest advancements in deprescribing research! /episode/index/show/geripal/id/34964275

Caring for the Unrepresented: A Podcast with Joe Dixon, Timothy Farrell, Yael Zweig 01/16/2025

Palliative Care for Mental Illness: A Podcast with Dani Chammas and Brent Kious 12/19/2024

AI for Surrogate Decision Making?!? Dave Wendler, Jenny Blumenthal-Barby, Teva Brender 12/12/2024

AI for Surrogate Decision Making?!? Dave Wendler, Jenny Blumenthal-Barby, Teva Brender Surrogate decision making has some issues. Surrogates often either don’t know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients. After making decisions, many surrogates experience regret, PTSD, and depressive symptoms. Can we do better? Or, to phrase the question for 2024, “Can AI do better?” Follow that path and you arrive at a potentially terrifying scenario: using AI for surrogate decision making. What?!? When Teva Brender and Brian Block first approached me about writing a about this idea, my initial response was, “Hell no.” You may be thinking the same. But…stay with us here…might AI help to address some of the major issues present in surrogate decision making? Or does it raise more issues than it solves? Today we talk with Teva, Dave Wendler, and Jenny Blumenthal-Barby about: Current clinical and ethical issues with surrogate decision making The (developed by Dave Wendler) or (updated idea by Brian Earp) and to comb through prior recorded clinical conversations with patients to play back pertinent discussions; to predict functional outcomes; and to predict patient preferences based on prior spending patterns, emails, and social media posts (Teva’s thought piece) A whole host of s raised by these ideas including the black box nature, the motivations of private AI algorithms run by for profit healthcare systems, turning an “is” into an “ought”, , and privacy. I’ll end this intro with a quote from Deb Grady in an to our in JAMA Internal Medicine about this topic: “Voice technology that creates a searchable database of patients’ every encounter with a health care professional? Using data from wearable devices, internet searches, and purchasing history? Algorithms using millions of direct observations of a person’s behavior to provide an authentic portrait of the way a person lived? Yikes! The authors discuss the practical, ethical, and accuracy issues related to this scenario. We published this Viewpoint because it is very interesting, somewhat scary, and probably inevitable.” - /episode/index/show/geripal/id/34404080

Stories We Tell Each Other to Heal: Ricky Leiter, Alexis Drutchas, & Emily Silverman 12/05/2024

Coping with Serious Illness: Danielle Chammas and Amanda Moment 11/21/2024

Falls and Fractures: A Podcast with Sarah Berry 11/14/2024

Dialysis vs Conservative Management for Older Adults: Manju Kurella Tamura, Susan Wong, & Maria Montez-Rath 11/07/2024

COVID Updates: A Podcast with Peter Chin-Hong and Lona Mody 10/31/2024

Medical Cannabis Revisited: A Podcast with David Casarett and Eloise Theisen 10/24/2024

Guidelines or Goals in Heart Failure: Parag Goyal, Nicole Superville, and Matthew Shuster 10/17/2024

Intentionally Interprofessional Care: DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace 10/10/2024

Intentionally Interprofessional Care: DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace In fellowship, one of the leaders at MGH used to quote Balfour Mount as saying, “You say you’ve worked on teams? Show me your scars.” Scars, really? Yes. I’ve been there. You probably have too. On the one hand, I don’t think interprofessional teamwork needs to be scarring. On the other hand, though it goes against my middle-child “can’t we all get along” nature, disagreement is a key aspect of high functioning teams. The key is to foster an environment of curiosity and humility that welcomes and even encourages a diversity of perspectives, including direct disagreement. Today we talk with DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace about the notion that we should revolutionize our education programs, training programs, teams, incentive structures, and practice to be intentionally interprofessional in all phases. The many arguments, theories, & approaches across settings and conditions are explored in detail in the book they edited, “” (discount code AMPROMD9). Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. In other words, in addition to being a specialist (e.g. social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. Many more approaches to being interprofessional on today’s podcast. But how about you! What will you commit to in order to be more intentionally interprofessional? If we build this dream together, standing strong forever, nothing’s gonna stop us now… -@AlexSmithMD Interprofessional organizations that are not specific to palliative care are doing excellent work National Center for Interprofessional Practice and Education: National Collaborative for Improving the Clinical Learning Environment Interprofessional Education Collaborative (home of the IPEC Competencies) American Interprofessional Health Collaborative (sponsor of the biennial meeting "Collaborating Across Borders") Health Professions Accreditors Collaborative This episode of the GeriPal Podcast is sponsored by , an amazing group doing world-class palliative care. They are looking to build on both their research and clinical programs and are interviewing candidates for the and for. To learn more about job opportunities, please click here: ** NOTE: To claim CME credit for this episode, ** /episode/index/show/geripal/id/33399027

Images of the Dying: A Podcast with Wendy MacNaughton, Lingsheng Li, and Frank Ostaseski 10/03/2024

Images of the Dying: A Podcast with Wendy MacNaughton, Lingsheng Li, and Frank Ostaseski Can death be portrayed as beautiful? In this episode, we share the joy of talking with (artist, author, graphic journalist) and (Buddhist teacher, author, founder of the and Zen Hospice Project) about using drawings and images as tools for creating human connections and processing death and dying. You may know Wendy as the talented artist behind or . Our focus today, however, was on her most recently published book titled . This beautiful book began as a very personal project for Wendy while she was the artist-in-residence at Zen Hospice. As BJ MIller writes in the foreword, “May this book be a portal -- a way for us to move beyond the unwise territory of trying to ‘do it right’ and into the transcendent terrain of noticing what we can notice, loving who we love, and letting death -- like life --surprise us with its ineffable beauty.” Some highlights from our conversation: The role of art in humanizing the dying process. How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go… The possibility of incorporating drawings in research and even clinical care. The wisdom and experiences of hospice caregivers (who are often underpaid and undervalued). How to use the “Five Things” as a framework for a “conversation of love, respect, and closure” with someone who is dying. And finally, Wendy offers a drawing lesson and ONE-MINUTE drawing assignment to help us (and our listeners) be more present and connect with one another. You can read more about this blind contour exercise from Wendy’s . The rules are really quite simple: Find another person. Sit down and draw each other for only one minute. NEVER lift up your pen/pencil (draw with a continuous line) NEVER look down at your paper That’s it! While the creative process is what truly matters, we think that the outcome is guaranteed to be awesome and definitely worth sharing. We invite you to post your drawings on twitter and tag us @GeriPalBlog! Happy listening and drawing, Lingsheng Additional info: For weekly lessons on drawing and the art of paying attention from Wendy, you can subscribe to her Substack and join the ! To learn more about Frank’s teaching and philosophy on end-of-life care, read his book This episode of the GeriPal Podcast is sponsored by , an amazing group doing world-class palliative care. They are looking to build on both their research and clinical programs and are interviewing candidates for the and for. To learn more about job opportunities, please click here: ** This podcast is not CME eligible. To learn more about CME for other GeriPal episodes, . /episode/index/show/geripal/id/33305172

Stepped Palliative Care: A Podcast with Jennifer Temel, Chris Jones, and Pallavi Kumar 09/19/2024

Well-being and Resilience: a Podcast with Jane Thomas, Naomi Saks, Ishwaria Subbiah 09/12/2024

Allowing Patients to Die: Louise Aronson and Bill Andereck 09/05/2024

Stump the VitalTalk Communication Experts: A Podcast with Gordon Wood, Holly Yang, Elise Carey 08/29/2024

What is Death? Winston Chiong and Sean Aas 08/22/2024

What is Death? Winston Chiong and Sean Aas We’ve talked about with Robert (Bob) Troug and guest-host Liz Dzeng, and in many ways today’s podcast is a follow up to that (apologies Bob for mispronouncing your last name on today’s podcast!). Why does this issue keep coming up? Why is it unresolved? Today we put these questions to Winston Chiong, a neurologist and bioethicist, and Sean Aas, a philosopher and bioethicist. We talk about many reasons and ways forward on this podcast, including: The ways in which advancing technology continually forces us to re-evaluate what it means to be dead - from the ability of cells/organs to revive, to a future in which organs can be grown, to uploading our consciousness to an AI. (I briefly mention the series by Denise Taylor - a science fiction series about an uploaded consciousness that confronts the reader with a re-evaluation of what it means to be human, or deserving of moral standing). The moral questions at stake vs the biologic questions (and links between them) The pressures the organ donation placers on this issue, and questioning if this is the dominant consideration (as Winston notes, organ donation was not central to the story) - the title of a great recent paper from Sean - which argues that “we must define death in moralized terms, as the loss of a significant sort of moral standing,” - noting that those why are “dead” have something to gain - the ability to donate their organs to others. Winston’s paper on the “fuzziness” around all definitions of brain death, titled, . As we joke about at the start - talking with philosophers and bioethicists, you almost always get a response along the lines of, “well that’s a good question, but let’s examine a deeper more fundamental question.” Today is no different. And the process of identifying the right questions to ask is absolutely the best place to start. Eventually, of course, . - /episode/index/show/geripal/id/32684782

GeriPal - A Geriatrics and Palliative Care Podcast

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