In this episode, we sit down with Dr. Ellie Fishbein, AKA @Geriatricsinreallife / Survivor extraodinaire / Improv extraodinaire / TikTok/Insta famous geriatrician to talk about loneliness and what to practically do about it. Oh, and we toss in a teensy Mad Lib.

Guest Bio: Dr. Ellie Fishbein is an Assistant Professor of Medicine in Geriatrics at Washington University School of Medicine. She earned her MD from Rush Medical College and completed her Family Medicine Residency and Geriatrics Fellowship at the University of Iowa Hospitals and Clinics. Dr. Fishbein is board-certified in Family Medicine and has a focus on geriatric care, providing comprehensive assessments and mentorship to residents. Her clinical expertise includes continuity of care and interdisciplinary approaches to managing complex geriatric conditions. She is also a recognized educator, receiving the 2024 Resident's Teacher of the Year Award.

Dr. Fishbein is the creator of @geriatricsinreallife, a widely followed educational platform on Instagram and TikTok, known for its practical and creative infographics that make complex geriatric concepts approachable for learners and clinicians alike.

Dr. Ellie's Instagram, @geriatricsinreallife: https://www.instagram.com/geriatricsinreallife

Dr. Ellie's TikTok, @geriatricsinreallife: https://www.tiktok.com/@geriatricsinreallife

Follow our Instagram, @verigeripodcast: https://www.instagram.com/verigeripodcast

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Show Notes: https://verigeripodcast.com/show-notes/f/18-call-your-grandma

Timestamps

00:44 Introductions

03:54 Defining loneliness, social isolation

07:08 Prevalence and health implications of loneliness

09:55 Case

15:32 Screening for loneliness in older adults

21:39 The 5 Ms

30:48 Mad Lib reveal

Co-Producers: Sam Ing, MD, Patty Lee, MD, Hannah O'Hagan, MD

Script Writer: Hannah O'Hagan, MD

Primary Editor: Sam Ing, MD

Show Notes Writer: Kylie McElheran, BS

Graphic designer: Patty Lee, MD

While our episodes are usually clinician-facing, our series of "Dear Patients and Families" are also patient-facing! This is the second episode in this series. Our first episode was #11: Dear Patients and Families: How to Navigate Dementia During the Holidays.

This episode looks at how to proactively take steps to plan and save money when a diagnosis of dementia is given. No matter what age we are, it can be intimidating to navigate finances of the healthcare system. Tessa tells us how to plan ahead. We go over a general acronym of approach, power of attorney roles, looking for in-home and out-of-home support, when care needs to escalate.

We're proud that this episode was written by Kylie McElheran, a medical student at OHSU, with awesome show notes and graphics all made by Jai Daniels, a medical student at University of Chicago.

Click here for SHOW NOTES!

Timestamps ● 00:00 Welcome & disclaimer; why finances surface after a new dementia diagnosis ● 04:00 The DIGNITY framework (Designate, Independence, Gather, Needs, Intentionality, Therapies, YOLO) ● 09:14 Healthcare vs. Financial Power of Attorney (differences, notarization, when to involve elder law) ● 10:42 Avoiding guardianship: costs, risks, and why early POA saves money and strain ● 13:34 Price Is Right safety items & costs (hearing amplifier, light bars, shower chair, bidet, fall-detect watch)

● 15:00 Subsidized in-home supports: homemakers, adult day, caregiver respite; paying a family caregiver ● 20:00 When home isn't enough: assisted living, supportive living (Medicaid), and memory care ● 27:30 Building a care mosaic (family/friends + subsidized hours + targeted private-pay gaps) ● 27:50 Finding & vetting facilities; waitlists; concierge placement services; planning "six months private-pay" to access a Medicaid bed ● 30:43 Life insurance hack: accelerated death benefits ● 31:18 Communication about finances: "Is the current plan working?"; gentle language about moving

Guest Bio: Tessa McEwen, LCSW has 20+ years of experience supporting diverse populations across nonprofit and medical settings, with a focus on personalized care and intergenerational connection. At UChicago Medicine, she primarily supports patients and families living with Alzheimer's disease and related dementias—working through the Memory Center and consulting across outpatient neurology and neurosurgery clinics. She is a global facilitator for Lorenzo's House, co-leading programs for youth and care partners impacted by dementia. A Schweitzer Fellowship recipient, Tessa centers grief support, cultural humility, and compassionate care. She co-founded Dementia Friendly Hyde Park, holds a BA in Sociology from the University of Notre Dame, and an MSW from the University of Chicago.Guest-Host and Writer Bio: Kylie McElheran, BS, grew up in Grants Pass, OR, and is now a third-year medical student at Oregon Health & Science University in Portland, OR. Before medical school, she worked in the clinical research industry for 6 years. In her free time, she loves hanging with her husband and dog, as well as playing board games while dabbling in Oregon's superb craft beer scene.

Co-Producers: Sam Ing, MD, Patty Lee, MD

Primary Editor: Sam Ing, MD

Graphic designer & Show Notes Writer: Jai Daniels, BA

Instagram: https://www.instagram.com/verigeripodcast

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WAIT! This is part 2 of non-cancer inpatient pain management in older adults (Part 1 is episode #15 with Dr. Thomas Chen, who talks about the pharmacology/theory of pain medications in older adults - check it out first!). In this episode, we jump into it - GeriPal physician Dr. James Brehany will focus on APPLICATION of foundational concepts. Spoiler alert - we will delve into a case of gabapentin, tramadol, SNRI, buprenorphine, common opioids, and then end with lightning rounds. And before all you palliative care peeps get your pants in a bunch, this episode focuses on NON-CANCER ACUTE INPATIENT PAIN, so you'll have to put that specific thinking cap on first. We don't touch on outpatient pain management, but resources will be on our show notes.

Guru Bio: Dr. James Brehany is Assistant Professor of Palliative Medicine at The Ohio State University, board certified in IM, palliative medicine, and geriatric medicine with clinical interests in overlap of addiction/pain, medical student education, and bioethics.

Guest Host Bio: Hannah O' Hagan is an Internal Medicine Resident at the University of Chicago.

Show Notes

Timestamps

Guru: James Brehany, MD

Guest Host: Hannah O'Hagan, MD

Show Notes Editor: Patty Lee, MD

Hosts: Patty Lee, MD, Sam Ing, MD

Tramadol, cyclobenzaprine, gabapentin, NSAIDs, oh my!

This episode of focuses on pain management in older adults, specifically pharmacological management of non-cancer related acute inpatient pain. This is part 1 of a two-part series. Part 2 will focus on application of pain management with opioids such as buprenorphine, oxycodone, and dilaudid in older adults. We're joined by Dr. Thomas Chen, MD, PharmD, an assistant professor of medicine and hospitalist at the University of Chicago, with expertise in clinical pharmacology and pharmacogenetics. Dr. Chen discusses the pharmacokinetics and pharmacodynamics changes in older adults that affect pain perception and medication efficacy. He also goes over the rationale for the 'start low and go slow' approach, the controversial use of Tramadol, and the pharmacogenomic considerations in prescribing pain medications like hydrocodone, codeine, gabapentin, cyclobenzaprine, and NSAIDs. Dr. Chen also shares his personal experiences and practical advice for managing pain in a hospital setting while emphasizing the importance of de-prescribing unnecessary medications.

SHOW NOTES!!!: HERE

As we're focused on management of acute inpatient pain in older adults, underutilized outpatient treatments such as CBT, nerve blocks, injections, and physical therapy are not covered. But many tools exist, with examples below - perfect for your next dotphrase:

• Many of the nonpharmacological options are outlined on geriatricpain.org, with short "Fast Facts" for patients, developed by the University of Iowa
• Also on geriatricpain.org is a comprehensive, patient-centered Caregiver Toolkit for assessing pain in your family member with dementia. It goes over Pain Assessment in Advanced Dementia (PAIN AD) Tool, Pain Thermometer, Pain Diary, etc.
• If you don't want to hog the clinic printer by printing that out, healthinaging.org also provides a shorter caregiver guide for pain. This is even shorter.
• I-COPE Toolkit: https://voices.uchicago.edu/icope/learn-about-i-cope/
• To find CBT for pain management, search American Psychological Association with the patient's zip code and practice area of "Pain Management"
• Your state or local county Office for the Aging may also be able to provide resources for support groups for chronic pain.

Timestamps

00:00 Introduction to Pain Management in Older Adults

01:45 Meet Dr. Thomas Chen: Background and Expertise

04:32 Understanding Pain Perception and Pharmacokinetics in the Elderly

07:13 The Tramadol Debate: To Use or Not to Use?

11:08 Exploring Alternatives: Hydrocodone and Codeine

13:57 Managing Acute Inpatient Pain: Non-Opioid Approaches

20:04 NSAIDs in Older Adults: Benefits and Risks

24:09 The Role of Acetaminophen and Final Thoughts

Guru: Thomas Chen, MD, PharmD

Guest Host/Co-Producer: Hannah O'Hagan, MD (University of Chicago IM PGY2)

Show Notes Editor: Kylie McElheran, BS (Oregon Health and Science University MS3)

Hosts: Patty Lee, MD, Sam Ing, MD

Guru Bio: Dr. Thomas Chen is an Assistant Professor of Medicine in the Section of Hospital Medicine at The University of Chicago, with a secondary appointment with the Committee on Clinical Pharmacology and Pharmacogenomics. Dr. Chen brings valuable experience as a former pharmacist, utilizing his medication expertise to contribute to research, patient care, and education. In addition to his clinical work as a hospitalist, he is the co-director of the Personalized Therapeutics Clinic, where he conducts extensive medication reviews for drug-drug and drug-gene interactions, also known as pharmacogenomics.

Dr. Chen actively engages in research within pharmacy-related areas and pharmacogenomics. He was a co-investigator for the NIH-funded study titled, "Implementation of Point-of-Care Pharmacogenomic Decision Support Accounting for Minority Disparities." Currently, he is a co-investigator for a clinical trial, the "PROTECT-Rx: Evaluating the Effectiveness of a Personalized Therapeutics Clinic Intervention on Drug-Drug Interactions and Drug-Gene Interaction."

Show Notes Editor Bio: Kylie McElheran, BS grew up in Grants Pass, OR and is now a third-year medical student at Oregon Health & Science University in Portland, OR. Before medical school, she worked in the clinical research industry for 6 years. In her free time, she loves hanging with her husband and dog, as well as playing board games whilst dabbling in Oregon's superb craft beer scene.

We hauled a big sign around to capture willing victims. Listen in to see what we got!

WHOOOOA! This is a SERIOUSLY SERIOUS EPISODE with powerhouses! In this episode of the VeriGeri podcast, we dive into the framework and nuances of serious illness conversations. Dr. Paige Barker, Dr. Karen Bullock, and Dr. Carine Davila cover the bread and butter of essentials in serious illness conversations but also take us through how to center on the patient with their individual experiences. We apply their foundation through a case in the middle and listen to tips about working with interpreters at the end.

Show notes: https://verigeripodcast.com/show-notes/f/serious-illness-conversations-a-patient-centered-approach

Bios:

Dr. Paige Barker, MD, is a clinician educator in general internal medicine with expertise in palliative care at the University of Florida. She's passionate about teaching palliative skills and improving serious illness communication. She is the Palliative and End of Life Curriculum Director at University of Florida College of Medicine and leads the Goals of Care workgroup at UF Health.

Dr. Karen Bullock, PhD, LICSW, FGSA, APHSW-C, is a Louise McMahon Ahearn Endowed Professor at Boston College School of Social Work and Global Public Health. She is a clinical social worker with expertise in health disparities, aging, serious illness care, and palliative care. She's led numerous federal grant funded research on equity, workforce development, and health sustainability. She is the John A. Hartford Faculty Scholar and has served on numerous national boards including SWHPN and the ACS Oncology Social Work Research Peer Review Committee. She is also the steering committee member for the Duke University REACH Equity Center and an affiliate faculty at the Center to Advance Palliative Care. She received the AAHPM Richard Payne Outstanding Achievement in Diversity, Equity, and Inclusion Award in 2024.

Dr. Carine Davila, MD, MPH, is a palliative care physician at Massachusetts General Hospital dedicated to improving access to quality care for marginalized populations. She is the equity director for the Division of Palliative Care and Geriatric Care. Medicine and co created the Palliative Care Health Equity Curriculum. Dr. Davila co leads United Against Racism efforts and conducts research on improving serious illness communication for Spanish speaking patients, clinicians, and interpreters.

Timestamps:

00:00 – Introduction to the Episode

00:57 – Meet Our Guest Experts

04:03 – Defining Serious Illness Conversations

08:41 – Asking Permission

10:30 – Thoughtfulness with Historically Marginalized Patients

17:12 – Brief Summary of Serious Illness Conversations

18:23 – Case One: Willie Jenkins

25:33 – Providing Recommendations Based on Patient Values

31:11 – Closing Remarks

• Just because people are aging doesn't mean they stop wanting or needing intimacy. In this episode, we dive into the often-overlooked topic of sexuality in older adults. Many healthcare providers hesitate to discuss sexual health with aging patients, often assuming they are no longer interested in sex. However, intimacy remains a crucial aspect of overall well-being. Our guests, Dr. Darlene Moyer and Dr. Travis Glenn, help us explore how to better support older patients in maintaining a fulfilling sex life.

• Show notes with summary and more detail: https://verigeripodcast.com/show-notes/f/sexuality-in-aging

• Episode timestamps

• Dr. Darlene Moyer's Bio:

• Dr. Travis Glenn's Bio:

• Guest Host Bio:

• Gurus:

In this special holiday episode, hosts Patty, Sam, and Megan, along with guest Tessa Garcia McEwen, discuss the challenges and strategies for caregivers and families of older adults with dementia during the holiday season. Tessa, a licensed clinical social worker with extensive experience in dementia care, shares valuable advice on modifications to holiday traditions, travel tips, and effective communication about dementia within families. This episode also covers coping techniques for grief and suggestions for engaging dementia patients in stimulating activities, emphasizing the importance of personalized care and support. We also learn about resources for grief counseling and practical tips for managing dementia symptoms in different environments.

Show Notes: https://verigeripodcast.com/show-notes/f/navigating-dementia-during-the-holidays

Please follow us on Instagram @verigeripodcast and follow us on Apple and Spotify! We are grateful to University of Chicago's BSD Office of Diversity and Inclusion for their support.

In this episode, we're lucky to have Josh Sevier, an audiologist who delves into his personal journey from being a trauma medic to an audiologist and shares valuable insights on hearing loss, its diagnosis, treatment options, and its broader health impacts. He shares about the evaluation process, recommendations for hearing aids, cochlear implants, and tips for communication strategies. We're proud that this episode was written by Nihar Rama, a current medical student at University of Chicago, with show notes written by Kylie McElheran, a medical student from Oregon Health and Science University. Check out the show notes here!

& check out cool graphic design by medical student Jai Daniels from University of Chicago on our instagram! Suscribe, like and follow - you know what to do!

Host Bio: Dr. Josh Sevier is an audiologist and clinical program manager of the cochlear implant program at UChicago Medicine. His clinical interests are research, objective measures, cognition, and training in cochlear implants, which he teaches about at multiple universities and publishes in numerous peer-reviewed journals. He's been involved with advocacy and legislation on a state and national level, including the Government Relations Committee for the American Academy of Audiology, Executive Board for the Illinois Deaf and Hard of Hearing Commission. He is the current President of the Illinois Academy of Audiology.

Guest Host Bio: Nihar is a third-year medical student at the University of Chicago Pritzker School of Medicine and a Cincinnati native. He is interested in pursuing a career in otolaryngology-head and neck surgery. Outside of medicine, Nihar loves staying active, playing and discovering music, and working on his comedic timing.

Writer: Nihar Rama, BS

Co-Producers: Nihar Rama, BS, Patty Lee, MD, Samantha Ing, MD

Primary editor: Patty Lee, MD

Graphic designer: Jai Daniels, BA

Timestamps:

1:20 Introductions

2:38 Josh's journey to becoming an audiologist

4:32 Signs that someone might have hearing loss

7:15 Social impacts of hearing loss in geriatric patients

8:41 Referrals to audiology and types of hearing loss

10:52 Audiology evaluation details

13:50 ENT vs. Audiology

15:07 Case of Liz Senning, communication strategies/tips for families

16:47 Hearing Aids (commitment, costs, insurance coverage)

21:22 OTC Hearing Aids

24:28 Cochlear implants

27:42 Case 2 (90 y/o patient with severe vascular dementia and hearing loss)

29:34 Recommendations for patients adjusting to hearing aids

We are grateful to the University of Chicago Biological Sciences Division Office of Diversity and Inclusion for support.

WELCOME TO SEASON 2!!!! This episode we're going a little bit back and going over the diagnosis and prognosis of dementia (see episode 7 for management of dementia). Does it take just a test score? A hunch? Probably not, but we'll go through the details. Our superstar guest is Dr. Sing Palat, MD (bio below), and our guest host is Andrew Dang, MD, a primary care physician. Don't forget to follow up on Instagram at @verigeripodcast!

Show notes

Guest bio:

Sing Palat MD, from Golden Colorado, completed her geriatrics fellowship at the University of Colorado after medical school and an internal medicine residency at the University of Pittsburgh. She is currently a medical director with Optum Senior Community Care, supporting clinicians practicing in long-term care communities. On weekends, she plays the piano, volunteers at The Well free clinic, and goes sightseeing with her husband and teenage son.

Time stamps:

02:55: what's the difference between normal aging and pathologic cognitive impairment?

05:45: what are some misconceptions about dementia?

07:15: what are some common questions about dementia, including family history?

08:45: how do you diagnose dementia?

10:13: Summary

11:27: Staging dementia

14:50: how often do you assess for progression?

16:05: how can families support their loved ones in diagnosis of dementia?

16:44: what can we counsel families about?

18:27: what about Andrew's experience in residency clinic?

19:22: how do you navigate assisted living services?

20:32: when should we start considering assisted living?

24:43: how do you help families try to preserve the patient's identity in dementia?

This episode was in part funded by the Small Grants Program at University of Chicago BSD Office of Diversity & Inclusion. We are truly grateful for the support.