GeriPal

Having experienced the value of home-based palliative care (HBPC) and recognizing the challenges it faces as it grows, my elective in HPBC left me wondering what the future will hold for this field. As a hospice and palliative medicine fellow about to embark on my career as an attending, I feel fortunate to be able to stand on the shoulders of my mentors and the many other pioneers in palliative care who helped build the field. It is only because of their work that I am able to be in the privileged position to look out on the future of HBPC and wonder about all that could be possible, knowing that so much of the path has already been paved.

With that sense of excitement, I wanted to open a discussion about where HBPC may be headed and to think about how the next generation of palliative care clinicians can build off the work of our predecessors to continue to refine HBPC to create a more patient-centered and seamless system of care for our patients. To help me in thinking about this …

Home-based palliative care is booming.  And with the growth of home-based palliative care come unique struggles and challenges: how can it be financed, what does the ideal team look like (or do you need a team?), retaining clinicians who may feel isolated doing this work, identifying patients who are most likely to benefit.

In this week's podcast we talk about these and other issues with Brook Calton, home-based palliative care physician in the Division of Palliative Medicine at UCSF and Grant Smith, a recent graduate of UCSF's palliative medicine fellowship now faculty at Stanford.

To supplement our podcast, Grant has written a series of thought pieces that flesh out and complement our discussion.  His first reflection was published in the Journal of Palliative Medicine last month.  We will post one additional reflection per day for the next three days.

Reflection #1: posted Friday, Feb 28, 2020
Reflection #2: posted Monday, Mar 02, 2020
Reflection #3: posted Tuesday, Mar 03, 2…

On this week's podcast we have the honor of talking with David Reuben about health care for older adults and how it's time to think different.   It really is a smörgåsbord of topics, ranging from how to think about population health for older adults (and how we as individuals providers can provide at least some level of population health), the UCLA Alzheimer's and Dementia Care Program and its outcomes, Medicare Advantage for All, working with community partners through voucher systems, and tips for leading change.

Dr. Reuben is Director of the Multicampus Program in Geriatrics Medicine and Gerontology and Chief of the Division of Geriatrics at the University of California, Los Angeles (UCLA). He is also the Archstone Foundation Chair and Director of the UCLA Claude D. Pepper Older Americans Independence Center and the UCLA Alzheimer's and Dementia Care program.

If you want to read more about some of the topics, check out these links:
Patient and Caregiver Benefit Fr…

We had fun on this in-studio podcast with Dan Matlock, geriatrician and palliative care clinician researcher at the University of Colorado, and frequent guest and host on GeriPal.  We most recently talked with Dan about Left Ventricular Assist Devices and Destination Therapy.

Today we talked with Dan about Implantable Cardiac Defibrillators (ICD) and Cardiac Resynchronization Therapy (CRT) - everything a geriatrician or palliative care clinician should know.  Dan and his team have developed a number of terrific decision aids around ICD implantation (see patientdecisionaid.org), and have seen uptake and use of these decision aids skyrocket following CMS's mandate requiring an shared decision making interaction prior to ICD implantation.

Enjoy!

-@AlexSmithMD








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TRANSCRIPT

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, we have-

Alex: Wa…

In this week’s podcast we talk about food insecurity in older adults with UCSF’s Hilary Seligman, MD. Hilary has done pioneering work in this area. Some of this work was funded by Archstone Foundation (full disclosure: Archstone is a GeriPal funder).

Hilary's expertise runs the gamut from federal nutrition programs (including SNAP), food banking and the charitable feeding network, hunger policy, food affordability and access, and income-related drivers of food choice.

I have a confession.  I knew almost nothing about food insecurity before this podcast.  Is it hunger? Why should we think about food insecurity and health in the same sentence? Why is this an issue for older adults in particular?

I was absolutely blown away by what I learned in this podcast. I have since quoted Hilary Seligman 4 or 5 times in other meetings.

Food insecurity is one of those topics that people don’t talk about but is likely far more critical to the health and well-being of the people we care about tha…