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PODCAST

GeriPal - A Geriatrics and Palliative Medicine Podcast

Alex Smith, Eric Widera

A geriatrics and palliative medicine podcast for every health care professional. Two UCSF doctors, Eric Widera and Alex Smith, 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. CME and MOC credit available (AMA PRA Category 1 credits) at www.geripal.org

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All Episodes

48:24

Transgender Health, Aging, and Advocacy: A Podcast...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/06/19

Happy Pride Month GeriPal listeners! Transgender issues are in the news. Just today (June 17th) as we record this podcast: Ezra Klein released a wonderful interview with Sarah McBride, the first openly transgender member of congress A judge ruled that cuts to NIH grants focused on minority groups, including transgender people, were illegal and ordered the government to restore funding. It’s Pride month, and our guests remind us of the leadership of two trans women in the Stonewall riots,

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49:44

What You Should Know About Radiation Oncology: A...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/06/12

If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. During my training, I didn’t receive much education about radiation oncology, and I’m not entirely sure what some of the terms mean (hypofractionated means fewer sessions, right?). Well, today’s podcast aims to clear up all these uncertainties. We’ve invited Anish Butala, the Chief of the Palliative Radiotherapy Service at Penn Medicine, and Emily Martin, a

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48:06

Implementing Palliative Care in Nursing Homes

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/06/05

The need for better palliative care in nursing homes is significant. Consider this: the majority of the 1.4 million adults residing in U.S. nursing homes grapple with serious illnesses, and roughly half experience dementia. Many also suffer from distressing symptoms like pain. In addition, about 25% of all deaths in the United States occur within these facilities. Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of

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48:55

Lucid Episodes: Andrea Gilmore-Bykovskyi & Andrew...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/05/29

Have any of you watched the movie “The Notebook”? At the end, one of the characters, who has dementia, experiences an episode of lucidity. When I watched it, between tears (I’m a complete softie) I remember thinking, “Oh no! This will give people false hope! That their loved one is ‘in there.’ If only they could find the right key to unlock the lock and let them out.” Today we talk about lucid episodes and what they might mean to the person with dementia, their family and loved ones, to

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42:03

Music as Medicine: Jenny Chen, Tyler Jorgensen, &...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/05/22

As you know, dear listeners, I love music. We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, today’s guests love music at least as much if not more than me, and they each make a strong case for music as medicine. Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Look for Jenny to potentially appear on the show America’s Got Talent (no lie). Tyler

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48:27

Nudges for Prognosis and Comfort Care in the ICU:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/05/15

Our main focus today was on nudging critical care clinicians to consider a more palliative approach to care. Our guests are all trained in critical care: Kate Courtright, Scott Halpern, and Jaspal Singh. Kate and Scott have additional training in palliative medicine. To start. we review: What is a nudge? Also called behavioral interventions, heuristics, and cognitive biases. Prior podcasts on the ethics of nudging, and a different trial conducted by Kate and Scott in which the default for

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46:57

Psilocybin in Serious Illness: A Podcast with James...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/05/08

We’ve covered psychedelics on the podcast before—first in 2019 with Ira Byock, where we explored their potential role in medicine, and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. In today’s episode, we’re taking a closer look at the current state of the science around one specific psychedelic: psilocybin. We'll discuss three recent clinical trials involving patients with serious illness,

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48:59

HIV, Aging, and Palliative Care: Peter Selwyn and...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/05/01

Peter Selwyn, one of today’s guests, has been caring for people living with HIV for over 40 years. In that time, care of people with HIV has changed dramatically. Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions. The average age at death was in the 30s. Now, more people in the US die with HIV rather than from HIV. Treatment regimens are simplified, and the anti-viral drugs are well

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45:26

Potentially Unsafe Low-evidence Treatments: Adam...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/04/24

More and more people are, “doing their own research.” Self-identified experts and influencers on podcasts (podcasts!) and social media endorse treatments that are potentially harmful and have little to no evidence of benefit, or have only been studied in animals. An increasing number of federal leaders have a track record of endorsing such products. We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently.

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47:18

Loss of DEI Hurts Everyone: Farah Stockman, Ali...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/04/17

I read Farah Stockman’s article in the NYT on why attacks on DEI will cost us all, 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 American Made: What Happens to People When Work Disappears, 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

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50:34

RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, &...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/04/10

Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. I asked 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 do the

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51:34

GeriPal Takeover! Nancy Lundebjerg and Annie...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/04/03

Whelp, goodbye folks! Eric and I have been DOGE’d. In a somewhat delayed April Fools, Nancy Lundebjerg and Annie Medina-Walpole have taken over podcast host duties this week. Their purpose is to interview me, Eric, and Ken Covinsky about your final AGS literature review plenary session taking place at the Annual Meeting in Chicago this May (for those attending, our session is the plenary the morning of May 10). We discuss our favorite articles, parody songs, and memories from AGS meetings past,

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47:04

Pragmatic Trial of ACP: Jennifer Wolff, Sydney Dy,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/03/27

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 pragmatic trial of advance care

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51:26

Hastening Death by Stopping Eating and Drinking: Hope...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/03/20

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 (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). 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

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48:50

The Roots of Palliative Care: Michael Kearney, Sue...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/03/13

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. Michael Kearney on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry.

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46:46

PC for People Experiencing Homelessness: Naheed Dosani

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/03/06

I was very proud to use the word “apotheosis” on today’s podcast. See if you can pick out the moment. I say something like, “Palliative care 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 earliest sketches included social suffering like

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51:26

PC for Patients with Substance Use Disorder: Janet...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/02/27

Much like deprescribing, 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 here, here, here, and here. 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

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47:07

Trauma-Informed Care: A Podcast with Mariah...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/02/20

Trauma is a universal experience, and our approach as health care providers to trauma should be universal as well. That’s my main take-home point after learning from our three guests today when talking about trauma-informed care, an approach that highlights key principles including safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. With that said, there is so much more that I learned from our guests for this trauma-informed care podcast. Our guests include

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47:19

Plenary Abstracts at AAHPM/HPNA: Yael Schenker, Na...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/02/13

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 (AAHPM) and the Hospice and Palliative Medicine Nurses Association (HPNA). 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

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47:52

How to Make an Alzheimer's Diagnosis in Primary Care:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/02/06

Things are changing quickly in the Alzheimer’s space. We now have biomarkers that can reasonably approximate the degree of amyloid build-up in the brain with a simple blood test. We have two new FDA-approved medications that reduce that amyloid buildup and modestly slow down the progression of the disease. So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? On today’s podcast, we’ve invited Nathaniel Chin back to the GeriPal

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