Gani

An age friendly health system is one in which everyone, from the doctors to the nurses to the people cleaning the rooms are aware of the unique needs of older adults.  These needs are categorized around the 4 M’s - Medication, Mentation, Mobility, and What Matters Most.   But we cannot achieve the ideal of an age friendly health system without, well, changing systems.  In this week’s podcast, we talk with Julia Adler- Milstein about the ways in which the electronic health records in hospitals and skilled nursing facilities are set up (or not set up) to document and track the 4 M’s.  We also talk with Stephanie Rogers about her work toward creating an age friendly health system at UCSF. Enjoy! -@AlexSmithMD    You can also find us on   Youtube !   Listen to GeriPal Podcasts on: iTunes  Google Play Music Soundcloud Stitcher TRANSCRIPT Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex: Thi...

  The Emergency Department (ED) is a hard place to have serious illness discussions, whether it be goals of care or code status discussions, or whether or not to consider intubation for a seriously ill patient.  Emergency physicians often don't have the time for in-depth discussions, nor have been trained on how to do so.  There often is limited information about the patient, their functional status, or their prognosis.  These are some of the most challenging and some of the most important conversations in medicine, as 75% of older adults visit the ED during the last 6 months of life ( data thanks to this Alex Smith publication in Health Affairs! )  So how do we have these urgent conversations in a time of crisis to ensure that patients receive care that aligns with their goals?  We have Naomi George, researcher and ED physician extraordinaire from the University of New Mexico, and Kai Romero from UCSF and Hospice by the Bay to help answer this question...

On todays podcast, we have Lauren Moo, a cognitive behavioral neurologist who has been doing video visits well before the COVID-19 pandemic to decrease the need for travel and to decrease the agitation in older adults with dementia that commonly occur when a clinic visits disrupts the usual routine.   Now with COVID among us, Lauren talks to us about her recently published JAGS article titled " Home Video Visits: 2‐D View of the Geriatric 5‐M s."   In the article and on the podcast, Lauren walks us through assessing the Geriatric 5M framework : mind, mobility, medications, multicomplexity, and what matters most.   Lauren gets very practical with us about how she does things like a cognitive assessments in this new medium of telemedicine.   One thing I'd like to note that we didn't talk about in our podcast, but Joe Ouslander wrote in the accompanying editors note to Lauren's article: "I recommend that you discourage patients and families fro...