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Showing posts from April, 2021

Life, Death, and a Hospital Strained by COVID: a Podcast with Brian Block, Sunita Puri and Denise Barchas

During the winter peak in coronavirus cases, things got busy in my hospital, but nothing close to what happened in places like New York City last spring or Los Angeles this winter.  Hospitals in these places went way past their capacity, but did this strain on the system lead to worse outcomes?  Absolutely. On today’s podcast, we talk with Brian Block, lead author of a Journal of Hospital Medicine study that showed that patients with COVID-19 admitted to hospitals with larger COVID-19 patient surges had an increased odds of death.   We talk about the findings in his study, which also included some variation in the surge hospitals as well as potential reasons behind these outcomes. We’ve also invited two other guests, Denise Barchas and Sunita Puri , to describe their hospital experiences in a COVID surge.  Denise is a ICU nurse at UCSF who volunteered in New York during the spring surge of COVID cases.  Sunita is the Medical Director of Palliative Medicine at USC’s Keck Hospital &

GeriPal's Newsletter is Moving

Hey GeriPal readers and listeners, A very quick update.  The GeriPal podcast is changing our service provider that our newsletter uses.  If you are already signed up for the newsletter, you don't need to sign up again, but do us a quick favor and do one of the following to avoid the newsletter getting stuck in your junk folder: Add to your email's contact list ( Click here to download GeriPal's vCard ) Add the email to your safe sender list We have a new post coming out Thursday morning from our new email address (, so if you don't see it in your inbox by Friday, look in your junk or quarantine folders.  If you are not yet on the newsletter list, sign up below with your email address (if you are not sure, put it in again as we remove all duplicates).  We aim for once a week updates so we won't clog up your inbox. Subscribe Thanks,  Eric and Alex PS.  If all you want

Disability in the home: Podcast with Sarah Szanton and Kenny Lam

  We know from study after study that most older adults would prefer to age in place, in their homes, with their families and embedded in their communities. But our health system is in many ways not particularly well set up to help people age in place. Medicare does not routinely require measurement or tracking of disability that leads many people to move out of their homes, and many interventions that support people to age in place are unfunded, underfunded, or funded by philanthropy rather than the government. Today we talk with Sarah Szanton, who created the CAPABLE multi-disciplinary model to help older adults stay at home, and Kenny Lam, who used a national study to examine the need for home-modification devices .  And we preview another of the AGS songs for the literature update - this one to the tune of “My Get up and Go” by Pete Seeger. Enjoy! -@AlexSmithMD

Capturing Pandemic Lessons Learned for Local Health Departments and Long-Term Care Facilities

by Sara Levin, David Farrell, Terry Hill, and Nicole Howell As with much of our pre-pandemic reality, the relationship between local health departments and long-term care facilities appears in retrospect to have been tranquil and routine.   Each year, local health departments offered influenza vaccine supplies to long-term care facilities and provided support for reportable communicable disease investigations as needed.   That relationship was upended with the advent in March 2020 of an expanding COVID-19 pandemic that would soon bring suffering and death to long-term care facilities.   The prior supports for infection prevention and control from federal, state, and local entities were wholly inadequate to address the COVID-19 tsunami.   For local health departments, rapid resource reallocation and improvisation became imperative.   Outbreak investigation and support teams blossomed in every local health department; phone calls and emails were numberless in both directions.   The suppo

All things Amyloid, including Aducanumab and Amyloid PET scans with Gil Rabinovici

  There are no currently approved disease modifying drugs for Alzheimer's disease, but in a couple months that may change.  In July of 2021, the FDA will consider approval of a human monoclonal antibody called Aducanumab for the treatment of Alzheimer's disease. If approved, it will not only make this drug the defacto standard of care for Alzheimer's disease, but will create a monumental shift in the usage of other currently limited diagnostic tests, including Amyloid PET scans and other biomarkers. On today's podcast, we talk about all things Amyloid, including Aducanumab and Amyloid PET scans with Gil Rabinovici .  Dr. Rabinovici is the Edward Fein and Pearl Landrith Endowed Professor in Memory & Aging at UCSF.    I could talk to Gil all day long, but we try to fit all of these topics in this jam-packed podcast: The heterogeneity of dementia and potentially Alzheimer's disease Where are we now with disease modifying treatments for Alzheimer’s disease The Role

Ageism + COVID19 = Elder Genocide: Podcast on nursing homes with Mike Wasserman

  One of our earliest COVID podcasts with Jim Wright and David Grabowski a year ago addressed the early devastating impact of COVID on nursing homes. One year ago Mike Wasserman, geriatrician and immediate past president of the California Long Term Care Association , said we’d have a quarter million deaths in long term care.  A quarter of a million deaths.  No one would publish that quote - it seemed inconceivable to many at the time.  And now, here we are, and the numbers are going to be close. In this podcast we look back on where we’ve been over the last year, where we are now, and what’s ahead. One theme that runs through the podcast is that if this level of death, confinement, and fear occured to any other population, change would have been swift.  But nursing home residents, for the most part, don’t have a voice, they’re not able to speak up, they lack power to move politicians and policy.   Mike Wasserman is a provocateur.  He is a needed voice for the nursing home residents an