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Priming Patients and Clinicians for Goals of Care Conversations: Podcast with Randy Curtis

In this week's GeriPal podcast we interview Randy Curtis, Professor of Medicine and Pulmonary Critical Care and Director of the Palliative Care Center of Excellence at the University of Washington.  

The issue is - how do we get more patients with chronic and serious illness to engage in goals of care conversations with their doctors?  One way is to train doctors in better communication techniques.  We've talked with folks - most recently Wendy Anderson - about Vital Talk and other such methods that approach the issue from that angle.

While acknowledging the critical importance of improving the quality of clinician communication, Randy's focus in the present study is priming patients and clinicians to engage in these conversations.  So how do you prime them?  Listen to the podcast to find out!  (bonus attempt to play Ed Sheeran)

Brief hint - patients are surveyed in advance to ascertain readiness and barriers to goals of care conversations.  Then, and this is brilliant, the c…
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Testimonials: Why Did You Go into Palliative Care Research?

Palliative care research is a relatively new field.  The number of researchers and the quality of the science is still inadequate to meet the need.  Many residents, fellows, and graduate students do not realize there are postdoc/fellowship opportunities that offer a pathway to becoming a palliative care researcher. 

I'm part of a group of faculty at palliative care research training programs around the country motivated to recruit and train the next generation of palliative care researchers.  Please follow this link to see a list of palliative care post-doctoral fellowship programs, information about each, and ways to contact program leadership to learn more.   Please also see this page of recorded webinar videos. We have 2 videos uploaded so far:Yael Shenker on Applying for Research Jobs in Palliative Care and Bob Arnold and 12 Books You Should Read to Have an Academic Career.

We'd like to enlist your help in spreading the message that palliative care research is a terrific …

Rethinking Advance Care Planning: A Podcast with Rebecca Sudore

On this weeks podcast, we invited Rebecca Sudore to talk about the results of her PREPARE randomized trial that was published in JAMA Internal Medicine this week.   The trial enrolled nearly 1,000 English and Spanish speaking older adults being cared for in a public hospital.

The headline results showed that after reviewing the PREPARE For Your Care online program and the easy-to-read advance directive, 98% of older adults reported increased engagement in advance care planning (ACP) and 43% had new ACP documentation in their medical record.   Even more good news, PREPARE worked equally well among English and Spanish-speakers and across health literacy levels.

So check out the podcast to learn more about Rebecca's work and these great links:

Rebecca's recent JAMA IM article on PREPAREOur podcast with Rebecca from a year ago on the initial trial also in JAMA IMThe PREPARE for Your Care website



Want even more of the GeriPal podcast? Watch the video of today's podcast below!
Ch…

Does “compassionate deception” have a place in palliative care?

by: Olivia Gamboa (@Liv_g_g)

There is broad consensus in the medical community that lying to patients is unethical.  However, in the care of patients with dementia, the moral clarity of this approach blurs.  In her recent New Yorker article, “The Memory House,”  Larissa MacFarquhar provides an excellent portrait of the common devices of artifice, omission and outright deception that are frequently deployed in the care of patients with dementia.  She furthermore explores the historical and ethical underpinnings of the various approaches used in disclosing (or not) information to patients living with dementia.

Ms. MacFarquhar introduces the idea of “compassionate deception,” or the concept that withholding truths, or even promoting outright falsehoods, is a reasonable and even ethical choice for those caring for patients with dementia.  To the extent that it helps a person with dementia feel happier and calmer, allowing them to believe in a gentler reality (one in which, say, their spo…

How do we serve the very sick, very frail, and very old? Podcast with Guy Micco

In this week's GeriPal podcast we talk with Guy Micco, MD, a longtime bioethicists, internist, hospice physician, teacher in the UC Berkeley and UCSF Joint Medical Program, mentor, and friend.  

Guy and I wrote an article recently for the journal Perspectives in Biology and Medicine about the intersection and issues between the fields of geriatrics, palliative care, and bioethics.  The main thrust of the paper is that we need a workforce that is trained in the principles of all three fields to take the best care of the very sick, the very frail, and the very old.  

And for those of you who listen, Guy sings a great rendition of Hello in There, by John Prine: sweet, sad, and sentimental.  

Chorus:
You know that old trees just grow stronger
And old rivers grow wilder every day
Old people just grow lonesome
Waiting for someone to say, "Hello in there, Hello."

Enjoy!

Links:
Bill Thomas on Reply All PodcastServing the Very Sick, Very Frail, and Very Old - article in Perspectives in Bio…