GeriPal - A Geriatrics and Palliative Medicine Podcast

We discuss with geriatrician, palliative care clinician, professor of medicine at Harvard Medical School, and author Muriel Gillick about the state of our current health care system for older adults as they journey through our health care system.

In this GeriPal Podcast we talk with Dr. Mark A. Supiano about a blood pressure management in older adults in the light of new evidence from the Systolic Blood Pressure Intervention Trial (SPRINT). In particular, we talk about a recent paper he co-author with Jeff Williamson in the Journal of the American Geriatrics Society (JAGS) titled "Applying the Systolic Blood Pressure Intervention Trial Results to Older Adults."

We talk with Dr. Jessica Zitter, a pulmonary critical care and palliative medicine physician, and author of Extreme Measures: Finding a Better Path to the End of Life. We talk with Jessica about her experience transitioning from being an ICU doctor to an ICU/Palliative doctor, how she is treated differently when she sees patients as an ICU attending vs a palliative care attending, the Big 3 (CPR, mechanical ventilation, and feeding tubes), and most importantly WHO she is wearing to the Oscars!

On todays podcast we interview Nathan Goldstein, MD, Chief of the Division of Palliative Care for Mount Sinai Beth Israel. We discuss his experiences and research focused on improving communication and the delivery of palliative care to patients with advanced heart failure.

On todays podcast, we talk with Vicki Jackson, Chief of the Palliative Care Division at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School, about her work in building the evidence base for palliative care.

Nursing home residents are often sent to the hospital for care that often offers little hope of improving quality of life or changing the course of illness. Some facilities though seem to do much better in preventing these "potentially burdensome hospitalizations". We discuss with Andrew Cohen, the lead author of a recent JAMA IM paper on this subject, to learn a little about what is in the secret sauce of these exceptional nursing homes.

Clinical formulations, something that few of us outside of mental health providers know about, but are critical in improving communication skills, especially around serious illness. Learn about them from our special guest, Dani Chammas, who makes the case that the single most valuable thing clinicians can do to improve communication is to get into the practice of developing a formulation.

On todays podcast, we talk with Angelo Volandes about the use of video to improve advance care planning.

Just in time for Thanksgiving, we are having an episode dedicated to the humble cranberry. We discuss the use of cranberries to preventing urinary tract infections with Dr. Manisha Juthani-Mehta. In addition to hearing about something called proanthocyanidin, we discuss her recent publication in JAMA on whether cranberry capsules decrease the presence of bacteriuria plus pyuria in older women living in nursing homes.

There are a lot of ways one can imagine on how to integrate palliative care into the intensive care unit (ICU). Today, we talk with ICU doctor and researcher, Bill Ehlenback, about his recent study of a proactive palliative care rounding intervention.

Truth telling is an ethical pillar of medicine. But, are there instances when it is ever ok to lie? In this episode of the GeriPal podcast we explore the use of deception and lies in modern healthcare, including those sweet little "therapeutic lies" commonly used in dementia care. For more about this topic, and some good articles about it, visit GeriPal.org.

This week's GeriPal podcast is all about mechanical ventilation in nursing home residents with advanced dementia. In particular, we discuss a new finding that use of mechanical ventilation doubled for these individuals from 2000 to 2013 without a substantial improvement in survival.

The second GeriPal podcast is a book review of "When Breath Becomes Air."

This is the first of the GeriPal podcasts focused on all things geriatrics, hospice, and palliative care.