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About

Mission:

GeriPal (Geriatrics and Palliative care) is a forum for discourse, recent news and research, and freethinking commentary. Our objectives are: 1) to create an online community of interdisciplinary providers interested in geriatrics or palliative care; 2) to provide an open forum for the exchange of ideas and disruptive commentary that changes clinical practice and health care policy; and 3) to change the world. We aim to be inclusive. We welcome the perspectives of generalists, specialists, gerontologists, palliative care clinicians, and anyone else interested in care of the elderly or palliative care. Anyone who wants to comment on a post is welcome -- just click the comment tab. Please email Eric Widera or Alex Smith if you are interested in being a regular contributor (you need to contact us to submit your own post).


Contributors include:
  • Theresa Allison
  • Bob Arnold
  • Helen Chen
  • Amy Corcoran
  • Ken Covinsky
  • Anne Johnson
  • Bree Johnston
  • Helen Kao
  • Chrissy Kistler
  • Leslie Kernisan
  • Sei Lee
  • Hillary Lum, MD, PhD
  • Nancy Lundebjerg
  • Susan Lysaght
  • Dan Matlock
  • Brad Miller
  • Aanand Naik
  • Carla Perissinotto
  • VJ Periyakoil
  • Alex Smith
  • Mike Steinman
  • Brad Stuart
  • Rebecca Sudore
  • Paul Tatum
  • Ori Tzvieli
  • Patrice Villars
  • Ron Walent
  • Eric Widera
  • Lindsey Yourman

Awards


Recognition

  • GeriPal has been mentioned in the NY Times, MSNBC, and the Lancet
  • GeriPal has been the focus of workshops at AGS, SGIM, and AAHPM annual meetings.


GeriPal Policies:
  • No confidential patient information should be placed on GeriPal, nor should any confidential information be placed in the comments. 
  • This web site does NOT accept advertisements. 
  • All email addresses collected by GeriPal for feed distribution will be kept confidential and will never be used for commercial reasons. 
  • The editors reserve the right to remove comments that are deemed inappropriate due to the commercial, abusive, or offensive nature of a comment. If you think your comment was deleted for inappropriate reasons, please email either Alex or Eric regarding your concern.
  • The information provided on GeriPal is designed to complement, not replace, the relationship between a patient and and his/her own medical providers. 


Further Information

GeriPal was created with the support of the Division of Geriatrics at the University of California, San Francisco. Its content though is strictly the work of its authors and has no affiliation with or support from any organization or institution. All opinions expressed on this website are solely those of its authors and do not reflect the opinions of any academic institution or medical center. If you reproduce the material on the website please cite appropriately.

For questions regarding the site please email Alex Smith, MD (aksmith@ucsf.edu) or Eric Widera, MD (eric.widera@ucsf.edu)

GeriPal

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Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
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Transcript

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

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …