VeriGeri

We finally tackle delirium!!! We always think we know it.....but the beast of delirium always keeps us guessing! For this episode we sail into the seas with our captain Dr. Jen Woodard, with guest host Dr. Krsna Kothari. We fearlessly go through some basic fish and chips then go through some cases as usual.

Disclaimer: Don't take any medical advice from this podcast. Always consult with your own physician on your medical decisions, and this podcast is not affiliated with any universities, hospitals, employment, etc. Thoughts and views are our own.

Guest Bios:

Jennifer Woodard, MD is a member of the Divisions of Hospital Medicine and Geriatrics and Gerontology in the Department of Medicine at University of Wisconsin-Madison. She serves as Associate Program Director for the Geriatrics Fellowship as well as the Chair of the Early Career Physicians Council for the Wisconsin American College of Physicians Chapter (ACP). Past honors include the Wisconsin ACP Chapter Resident of the Year Award, Winner of the Society for General Internal Medicine Bite-Size Teaching Competition for the Midwest Region, Winner of the Wisconsin ACP and Society of Hospital Medicine Oral Case Report Presentation, recipient of the Geriatrics and Gerontology Education and Research (GGEAR) Program Award, and Maryland ACP Chapter Philip A. Mackowiack Award for Medical Student Excellence. She is a member of the American Geriatrics Society, Society for General Internal Medicine, and American College of Physicians. Dr. Woodard provides consultative geriatrics care for older adults in the inpatient setting at University Hospital and East Madison Hospital. She also provides care for adult hospitalized patients at both hospitals and through the Home Based Hospital Care program. Her clinical interests include interprofessional and patient-centered communication, delirium, and quality improvement and patient safety.

Guest Host Bio: Krsna Kothari, MD is a star Med-Peds PGY3 resident at University of Illinois Chicago. She went to the University of Michigan for undergrad, then Mount Sinai Medical School.

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Show Notes: https://verigeripodcast.com/show-notes/f/21-delirium-with-dr-jennifer-woodard

Timestamps

🌟 Celebrate with us! We're marking our 20th episode with a special reintroduction. Join us as we reflect on our journey to geriatrics, share personal stories, and ask each other deep questions we never asked for. We'll talk about our inspiration and quick takes in geriatrics, review fave VeriGeri episodes and share what it's like to be a new attending in geriatrics. Discover our aspirations, from marathon dreams to foodie confessions, and how we navigate the challenges and joys of this journey. Tune in and find out! 🎧

Ope, we're back! Sorry for our lil hiatus as Patty was getting used to her new job. Well guess what? We did NOT hold back this episode. We talked with Geriatrician Dr. Emily Morgan on when to assess and communication tips, Occupational Therapist/certified driving rehab specialist Marisa Palandri for a backseat look on how driving rehab sessions work, and Social Worker Tessa Garcia McEwen on more communication tips for anticipated detours and possible potpholes, with how to have transportation replacement at the ready. We know that this is a gnarly topic because state guidelines differ, but we feel that it's important to have these ready to go for all patients.

Disclaimer: Don't take any medical advice from this podcast . Always consult with your own physician on your medical decisions, and this podcast is not affiliated with any universities. Thoughts and views are our own.

Guest Bios:

Emily Morgan, MD is a graduate of Oregon Health and Science University Medical School, where she stayed on to complete her internal medicine residency, followed by a fellowship in geriatrics. She is currently an Associate Professor of Internal Medicine and Geriatrics at OHSU where she has a geriatric primary care practice. In addition to her outpatient work, she is the head of the OHSU Internal Medicine Post-Acute and Long-term Care (PALTC) team and is Medical Director of Mirabella Portland PALTC. Her research focus is on improving geriatrics care in primary care and PALTC settings.

Marisa Palandri, OT, CDRS completed her undergraduate degree at Portland State University and earned her Master's Degree in Occupational Therapy from Pacific University in 2011. Since then, she has worked for Shepherd Center in Atlanta, Georgia, helping adults and teenagers with spinal cord injuries, strokes, and brain injuries learn how to regain their independence. She earned her certified driver rehabilitation specialty in 2018 to be able to help those same clients with neurologic injuries. She is the President of Bridges, a nonprofit that helps give more access to driving evaluations and specialty training for individuals all over the state of Oregon.

Tessa McEwen, AM, LCSW, DCCS, CDP 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 Bio: Megan Teramoto, BS, MS, is a first year medical student at the Pritzker School of Medicine. She received her Bachelor's and Master's degrees after studying Biochemistry at the University of Arizona. Outside of school, Megan enjoys volunteering and hiking.

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Show Notes: https://verigeripodcast.com/show-notes/f/driving-retirement-when-and-how-to-talk-about-it

Timestamps

Co-Producers: Patty Lee, MD, Sam Ing, MD, Megan Teramoto, BS, MS

Script Writer: Megan Teramoto, BS, MS

Primary Editor: Patty Lee, MD

Show Notes Writer: Patty Lee, MD

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

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Please subscribe to our podcast to get the word out!

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: