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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

health & fitness medicine

All Episodes

52:07

Medical Cannabis Revisited: A Podcast with David...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/10/24

Cannabis is complicated. It can mean many things, including a specific type of plant, the chemicals in the plant, synthetic analogs, or products that have these components. The doses of the most widely discussed pharmacologically active ingredients, THC and CBD, vary by product, and the onset and bioavailability vary by how it is delivered. If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients

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48:28

Guidelines or Goals in Heart Failure: Parag Goyal,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/10/17

When treating heart failure, how do we distinguish between the expanding list of medications recommended for “Guideline Directed Medical Therapy” (GDMT) and what might be considered runaway polypharmacy? In this week’s podcast, we’ll tackle this crucial question, thanks to a fantastic suggestion from GeriPal listener Matthew Shuster, who will join us as a guest host. We’ve also invited two amazing cardiologists, Parag Goyal and Nicole Superville, to join us about GDMT in heart failure with reduced

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47:56

Intentionally Interprofessional Care: DorAnne...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/10/10

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

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49:50

Images of the Dying: A Podcast with Wendy...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/10/03

Can death be portrayed as beautiful? In this episode, we share the joy of talking with Wendy MacNaughton (artist, author, graphic journalist) and Frank Ostaseski (Buddhist teacher, author, founder of the Metta Institute 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 Meanwhile in San Francisco or Salt Fat Acid Heat. Our focus today, however, was on her most recently

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50:17

Stepped Palliative Care: A Podcast with Jennifer...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/09/19

If palliative care was a drug, one question we would want to know before prescribing it is what dose we should give. Give too little - it may not work. Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? On today’s podcast, we talk about finding an evidence-based answer to this dosing question with three

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50:50

Well-being and Resilience: a Podcast with Jane...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/09/12

Well-being and resilience are so hot right now. We have an endless supply of CME courses on decreasing burnout through self-care strategies. Well-being committees are popping up at every level of an organization. And C-suites now have chief wellness officers sitting at the table. I must admit, though, sometimes it just feels off… inauthentic, as if it's not a genuine desire to improve our lives as health care providers, but rather a metric to check off or a desire to improve productivity and billing

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49:03

Allowing Patients to Die: Louise Aronson and Bill...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/09/05

In today’s podcast we set the stage with the story of Dax Cowart, who in 1973 was a 25 year old man horribly burned in a freak accident. Two thirds of his body was burned, most of his fingers were amputated, and he lost vision in both eyes. During his 14 month recovery Dax repeatedly demanded that he be allowed to die. The requests were ignored. After, he said he was both glad to be alive, and that the doctors should have respected his wish to be allowed to die. But that was 1973, you might say. We

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48:06

Stump the VitalTalk Communication Experts: A Podcast...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/08/29

Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. That’s a hard enough task, given that most of us have never had any communication skills training. It feels nearly impossible if you add another degree of difficulty, whether it be a crying interpreter or a grandchild from another state who shows up at the end of a family meeting

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48:15

What is Death? Winston Chiong and Sean Aas

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/08/22

We’ve talked about Brain Death before with Robert (Bob) Troug and guest-host Liz Dzeng, and in many ways today’s podcast is a follow up to that episode (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

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46:00

Anti-Asian Hate: Russell Jeung, Lingsheng Li, &...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/08/15

Anti-Asian hate incidents rose dramatically during COVID, likely fueled by prominent statements about the “Chinese virus.” VIewed through the wider lens of history, this was just the latest in a long experience of Anti-Asian hate, including the murder of Vincent Chin, the Chinese Exclusion Act, and the internment of Japanese Americans during WWII. For those who think that anti-Asian hate has receded as the COVID has “ended,” just two days prior to recording this episode a Filipino woman was pushed

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51:42

Optimizing Nutrition in Aging: A Podcast with Anna...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/08/01

What is a healthy diet and how much does it really matter that we try to eat one as we age? That’s the topic of this week's podcast with three amazing guests: Anna Pleet, Elizabeth Eckstrom, and Emily Johnston. Emily Johnston is a registered dietitian, nutrition researcher, and Assistant professor at NYU. Anna Pleet is an internal medicine resident at Allegheny Health Network who has a collection of amazing YouTube videos on aging and the Mediterranean diet. Elizabeth Eckstrom is a geriatrician,

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49:09

Prognosis Superspecial: A Podcast with Kara Bischoff,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/07/25

We are dusting off our crystal balls today with three amazing guests who have all recently published an article on prognosis over the last couple months: Kara Bischoff, James Deardorff, and Elizabeth Lilley. To start us off we talk with Kara Bischoff about the article she just published in JAMA Network on a re-validation of the Palliative Performance Scale (PPS) in a modern day palliative care setting. Why do this? The PPS is one of the most widely used prognostic tools for seriously ill

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51:58

Screening for Dementia: A Podcast with Anna Chodos,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/07/19

The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Are there, though, populations that it may be helpful in, or should that change with the advent of the new amyloid antibodies? Should it? If so, how do we screen and who do we screen? On this week’s podcast we talk with three experts in the field about screening for dementia. Anna Chodos is a geriatrician at UCSF and

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47:39

Ageism and Elections: Louise Aronson and Ken Covinsky

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/07/16

Emergency podcast! We’ve been asked by many people, mostly junior/mid career faculty, to quickly record a podcast on ageism and the elections. People are feeling conflicted. On the one hand, they have concerns about cognitive fitness of candidates for office. On the other hand, they worry about ageism. There’s something happening here, and what it is ain’t exactly clear. We need clear eyed thinking about this issue. In today’s podcast, Louise Aronson, author of Elderhood, validates that this

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51:24

Palliative Care in Liver Disease: A Podcast with...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/07/11

In May we did a podcast on KidneyPal (the integration of palliative care in renal disease), which made us think, hmmm… one organ right next door is the liver. Maybe we should do a podcast on LiverPal? (or should we call it HepatoPal?) On today’s podcast, we do that by inviting four palliative care leaders who are integrating palliative care into the care of those with liver disease: Kirsten Engel, Sarah Gillespie-Heyman, Brittany Waterman, and Amy Johnson. It’s a jampacked 50 minutes, filled with

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56:18

Anxiety in Late Life and Serious Illness: A Podcast...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/06/27

“Anxiety is a lot like a toddler. It never stops talking, tells you you’re wrong about everything, and wakes you up at 3 a.m.” I’m not sure who wrote this quote, but it feels right to me. We’ve all had anxiety, and probably all recognize that anxiety can be a force of action or growth but can also spiral to quickly take over our lives and our sleep. How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? On today’s podcast,

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45:06

Urinary Incontinence Revisited: George Kuchel &...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/06/20

I have to start with the song. On our last podcast about urinary incontinence the song request was, “Let it go.” This time around several suggestions were raised. Eric suggested, “Even Flow,” by Pearl Jam. Someone else suggested, “Under Pressure,” but we’ve done it already. We settled on, “Oops…I did it again,” by Britney Spears. In some ways the song title captures part of the issue with urinary incontinence. If only we lived in a world in which much of urinary incontinence was viewed as a

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48:37

Cachexia and Anorexia in Serious Illness: A Podcast...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/06/13

I always find cachexia in serious illness puzzling. I feel like I recognize it when I see it, but I struggle to give a clear definition or provide effective ways to address it. In today's podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. Eduardo established one of the first palliative care programs in 1984, created the Edmonton Symptom Assessment Scale (ESAS), and significantly contributed to the

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51:47

Sexual Function in Serious Illness: Areej El-Jawahri,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/06/06

As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. How long they might have to live. Their declining cognitive abilities. What makes their lives meaningful, brings them joy, a sense of purpose. But one issue we’re not as good at discussing with our patients is sexual health. On today’s podcast Areej El-Jawahri, oncologist specializing in blood cancers at MGH, says that sexual health is one of the top if not the top issue among cancer survivors.

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45:48

Palliative Care for Kidney Failure: Sam Gelfand, Kate...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2024/05/30

The landscape of options for treating people with kidney failure is shifting. It used to be that the “only” robust option in the US was dialysis. You can listen to our prior podcast with Keren Ladin talking about patients who viewed dialysis as their only option, and structural issues that led to this point (including this takedown of for profit dialysis companies by John Oliver). One of the problems was a lack of an alternative robust option to offer patients. As one of our guests says, you

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