Alex Smith
Gross National Happiness, Geriatrics, and Palliative Care
I saw one of my favorite philosophers speak yesterday: Peter Singer. His book Animal Liberation is reason I became a vegetarian for 3 years…until I was an intern, post-call, hungry, and it was “rib day”. It was either a baked potat…
Name 5 Tests or Treatments We Overuse in Geriatrics or Palliative Care
For the most part in geriatrics and palliative care we like to point the finger at other medical providers and say, “STOP.” Stop giving so much chemotherapy. Stop giving so many medications. Stop scanning.
But now it’s time to take…
“Elders?” “Older Adults?” “Seniors?” Language Matters
In a recent paper, some colleagues and I held the position that clinicians should routinely offer to discuss prognosis with very elderly patients.
I was later interviewed about this paper by a reporter who revealed that she is in her 70’s. She as…
When Surrogates Override the DNR: A Terrific Geriatrics and Palliative Care Teaching Video
I’d like to draw GeriPal readers’ attention to a terrific article from the Journal of the American Geriatrics Society called, “When Doctors and Daughters Disagree: Twenty-two Days and Two Blinks of an Eye.” The paper is by Peter Abadir, To…
Glen Campbell: Still Performing with Alzheimer’s
My neighbor told me recently about a musician named Glen Campbell who is still performing despite Alzheimer’s dementia. This shows my age, but I had never heard of him.
His story is inspiring for the support he is receiving for continuing …
Potpourri from Clinical Work VI
Palliative care fellow Katherine Aragon (right) and intern Sara Murray displaying their lightweight portable chairs (they have a shoulder strap as well)
Just finished another couple of weeks attending on the palliative care service, and wanted to sh…
Eprognosis gets Half a Million Hits in the First Week
Eprognosis is barely a week old, and we’ve already had over 500,000 pageviews (150,000 unique visitors). For perspective, GeriPal is about 3 years old, and in that time we’ve had 400,000 pageviews. We’ve had loads of press, including 6 …
Should for-profit hospices be banned? Or are they victims of a witch hunt?
10 year stock price of Gentiva, the nation’s fastest growing for-profit hospice provider
For-profit hospice has been in the news recently, and the press has not been favorable. We have this from a recent lengthy article in the Washington …
Potpourri from Clinical Work V
The following observations and questions came up during my recent work as palliative care attending. Thoughts and responses are welcome:
How well do so-called “bridge” programs work? These are the home-care programs for patients who qua…
The Hospital Disability Syndrome
Ken Covinsky previously posted on GeriPal a while back about the dangers of hospitalization in older adults. Ken notes in that post that hospitalization is a vulnerable period leading to major new disability for many older adults. More r…
Take the "H" out of AAHPM/HPNA? Let’s Discuss.
Should the word “hospice” be taken out of the professional society names: “American Academy of Hospice and Palliative Medicine,” and “Hospice and Palliative Nurses Association?” AAHPM would become AAPM. HPNA would become PNA.
This idea i…
Three times higher rates of surgery before death in Munster, Indiana than Honolulu, Hawaii
A McMansion in Munster, IN, from Wikimedia Commons
Honolulu, HI, from Wikimedia Commons
Following up on our previous post about study that hinted at substantial regional variation in the effectiveness of advance directives, a new study in the Lan…
Advance directives reduce end-of-life costs in New York and Los Angeles
Image from the Dartmouth Atlas: http://www.dartmouthatlas.org/data/region/
When have advance directives ever been shown to do anything? They were a complete failure in SUPPORT. Study after study demonstrates that few people fill them out…
