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Lost in Translation: Google’s Translation of Palliative Care to ‘Do-Nothing Care’

by: Cynthia X. Pan, MD, FACP, AGSF (@Cxpan5X)

My colleagues often ask me: “Why are Chinese patients so resistant to hospice and palliative care?” “Why are they so unrealistic?” “Don’t they understand that death is part of life?” “Is it true that with Chinese patients you cannot discuss advance directives?”

As a Chinese speaking geriatrician and palliative care physician practicing in Flushing, NY, I have cared for countless Chinese patients with serious illnesses or at end of life.  Invariably, when Chinese patients or families see me, they ask me if I speak Chinese. When I reply “I do” in Mandarin, the relief and instant trust I see on their faces make my day meaningful and worthwhile.

At my hospital, the patient population is about 30% Asian, with the majority of these being Chinese. Most of these patients require language interpretation.  It becomes an interesting challenge and opportunity, as we often need to discuss advance directives, goals of care, and end of life care options…
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AGS19: Super Fun Time Sing Along - Song Parodies

We had a tremendous amount of fun at the American Geriatrics Society (AGS) annual meeting this year presenting the Geriatrics Literature Update.  After each article that Ken Covinsky and Eric Widera eruditely summarized and explained, we had an audience sing-along to a parody of well-known songs.

This year, Ken insisted on more wholesome songs, the sort of songs Julie Andrews would sing in a musical.  We mostly stuck to that...but how can you not sing Grunge when you're in the Pacific Northwest?!?

So if you missed AGS this year or want to relieve this experience, check out the video our fantastic audio-visual guru Tim Stuck put together.  Just click play below, or if no image is showing, click this link to go straight to the YouTube video.  Note that each article discussed appears at the start, with a QR code that will take you straight to the article if you point your phone's camera at it in picture taking mode (don't even need to take a picture).

See below the video for…

Delirium: A podcast with Sharon Inouye

In this week's GeriPal podcast we discuss delirium, with a focus on prevention. We are joined by internationally acclaimed delirium researcher Sharon Inouye, MD, MPH. Dr Inouye is Professor of Medicine at Harvard Medical School and Director of the Aging Brain Center in the Institute for Aging Research at Hebrew SeniorLife.

Dr. Inouye's research focuses on delirium and functional decline in hospitalized older patients, resulting in more than 200 peer-reviewed original articles to date. She has developed and validated a widely used tool to identify delirium called the Confusion Assessment Method (CAM), and she founded the Hospital Elder Life Program (HELP) to prevent delirium in hospitalized patients.

We are also joined by guest host Lindsey Haddock, MD, a geriatrics fellow at UCSF who asks a great question about how to implement a HELP program, or aspects of the program, in a hospital with limited resources.  


You can also find us on Youtube!


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Are Palliative Care Providers Better Prognosticators? A Podcast with Bob Gramling

Estimating prognosis is hard and clinicians get very little training on how to do it.  Maybe that is one of the reasons that clinicians are more likely to be optimistic and tend to overestimate patient survival by a factor of between 3 and 5.  The question is, aren't we better as palliative care clinicians than others in estimating prognosis?  This is part of our training and we do it daily.   We got to be better, right? 

Well, on todays podcast we have Bob Gramling from the Holly and Bob Miller Chair of Palliative Medicine at the University of Vermont to talk about his paper in Journal of Pain and Symptom Management (JPSM) titled “Palliative Care Clinician Overestimation of Survival in Advanced Cancer: Disparities and Association with End of Life Care”.

Big findings from this JPSM paper include that we, like all other clinicians, are an optimistic bunch and that it actually does impact outcomes.   In particular, the people whose survival was overestimated by a palliative care c…

Multimorbidity - Quantifying It's Impact on Mental and Physical Health: A podcast with Melissa Wei

On today's podcast we talk with one of the national experts on multimorbidity, Melissa Wei.   Dr. Wei is an Assistant Professor and physician researcher at the University of Michigan.   In addition to destroying the lyrics to Bohemian rhapsody, we talk to Dr. Wei about how we should conceptualize multi morbidity, it's impact on older adults, and about her recent JAGS publication titled "Multimorbidity and Mental Health-Related Quality of Lifeand Risk of Completed Suicide."

We also go a little deeper into a measure of multimorbidity that Melissa created, the Multimorbidity Weighted Index (MWI) that weights diseases to patient reported physical functioning.  The MWI is associated with physical and cognitive function and mortality.  If you listen to the podcast, you'll notice that we also mention ePrognosis.  That's because Melissa's Multimorbidity-Weighted Index can now be found on the site (https://eprognosis.ucsf.edu/mwi.php).

So take a take a look at he…