VeriGeri

#21: Delirium with Dr. Jennifer Woodard, Geriatrician and Hospitalist

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. Follow our Instagram, @verigeripodcast: https://www.instagram.com/verigeripodcast Please subscribe to our podcast to get the word out! Show Notes: https://verigeripodcast.com/show-notes/f/21-delirium-with-dr-jennifer-woodard Timestamps 1 0:01 Intro 2 0:37 Disclaimer 3 0:52 Welcome & Introductions 4 1:14 Meet Dr. Woodard & Sailing Theme 5 2:42 Defining Delirium: CAM Score 6 5:51 Delirium Screening Tools Summary 7 8:55 Explaining Delirium to Families 8 10:27 Delirium vs. Dementia & Cognitive Testing 9 15:32 Like & Subscribe 10 16:03 Clinical Significance of Delirium 11 17:01 BUMPSS Mnemonic 12 18:33 Case 1: Delirium Prevention 13 21:58 Risk Factors & High-Risk Populations 14 23:52 Case 2: Managing Acute Delirium 15 25:12 BUMPSS Workup & TADA Method 16 29:46 Creative Interventions for Agitation 17 32:16 Case 3: Behavioral Emergency 18 33:18 When Patients Refuse Screening 19 34:48 Antipsychotics for Agitation 20 37:43 Special Situations: QTc & Parkinsonism 21 38:48 Physical Restraints 22 40:14 Summary & Outro

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#20: Who we are & being new Geriatricians

🌟 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! 🎧 01:04 Question Game Setup 01:55 Missing Co Fellows 06:00 Grandparents Influence 07:05 Work Life Balance 08:27 Deeper Family Stories 13:19 Why Geriatrics 17:05 Favorite Podcast Moments 17:57 Teaching With VeriGeri 18:55 Geriatrics Pet Peeves 20:48 What Geriatricians Do 21:58 Reality Of GeriPal Jobs 22:58 Delirium Comfort Hacks 23:26 Choosing Fellowship Fit 24:18 Becoming A New Attending 27:00 Rose/Thorn Of Attendinghood 29:26 Hot Takes And Mentors 30:28 Vulnerability And Friendship 31:20 Why We Met Finale

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#19: Driving Retirement: When and How to Talk About It

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. Follow our Instagram, @verigeripodcast: https://www.instagram.com/verigeripodcast Please subscribe to our podcast to get the word out! Show Notes: https://verigeripodcast.com/show-notes/f/driving-retirement-when-and-how-to-talk-about-it Timestamps 00:00 Driving Retirement Intro 00:23 Meet The Guests 01:45 Show Disclaimer 02:21 Warmup Game 03:56 Why Driving Safety Matters 06:34 Case One Routine Screening 09:33 Case Two Memory Concerns 12:48 Red Flags And Referrals 19:15 OT Driving Rehab Explained 23:38 Driving Outcomes Checklist 24:47 Behind The Wheel Context 26:00 Retesting And Provider Questions 26:57 Four Results Recap 27:51 Alzheimers Case Setup 28:42 MoCA And Framing 31:44 No Reporting Language 32:10 Social Worker Strategies 33:50 When Patients Refuse 37:37 Keeping Cars Inaccessible 38:46 Independence Without Driving 40:19 Local Transport Programs in Chicago 44:00 Key Takeaways And Closing 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

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#18: CALL YOUR GRANDMA! Why loneliness in older adults is more than just being alone with Dr. Ellie Fishbein - @Geriatricsinreallife

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 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

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#17: Dear Patients & Families: Stretching the Dollars of Dementia with Tessa Garcia McEwen, AM, LCSW, DCCS, CDP

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 Please subscribe and rate our show 5 stars - that helps to get the word out for our show.

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#16: Acute Inpatient Pain in Older Adults Part 2: Beyond Acetaminophen with GeriPal Dr. James Brehany

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 00:00 Introduction and Disclaimers 00:11 Meet the Hosts and Guest 00:26 Journey into Geriatrics and Palliative Care 02:23 Case Introduction: Ms. Peach 04:03 Medication Review and Pain Management 07:24 Deprescribing and Delirium 11:20 Types of Pain and Management 14:14 Creating the Pain Management Plan 30:46 Lightning Round: Quick Fire Questions 34:33 Conclusion and Credits Guru: James Brehany, MD Guest Host: Hannah O'Hagan, MD Show Notes Editor: Patty Lee, MD Hosts: Patty Lee, MD, Sam Ing, MD

#15: Acute Inpatient Pain Management in Older Adults Part 1: Don't Fear the Pharm with Hospitalist Dr. Thomas Chen, MD, PharmD

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.

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#14: Live from #AGS25: VeriGeri Podcast on the Street!

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

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#13: Refining serious illness conversations: a patient-centered approach with Dr. Paige Barker, MD, Dr. Karen Bullock, PhD, LICSW, FGSA, APHSW-C, and Dr. Carine Davila, MD, MPH

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 Graphic Designer & Show Notes Editor: Jai Daniels, BA Peer reviewers: Jason Lyou, MD, Shaina Fuller, MPH 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

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#12: Sexuality in Aging with Dr. Darlene Moyer and Dr. Travis Glenn

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 00:00 Introduction to Sexuality in Older Adults 01:01 Meet the Experts: Dr. Moyer and Dr. Glenn 02:40 Medieval Theme and Fun Facts 03:28 Defining Sex and Taking Sexual Histories 08:47 Addressing Sexual Health in Older Adults 09:45 Case One: Erectile dysfunction 15:18 Types of toys 18:37 Case Two: Pain during sex 21:30 Types of lubricants 24:11 Advice 25:36 Episode Recap and Closing Remarks Dr. Darlene Moyer's Bio: Originally from Pennsylvania, Dr. Darlene Moyer completed medical school at the George Washington University School of Medicine followed by a Family Medicine Residency and Geriatric Fellowship at HonorHealth in Scottsdale, Arizona. Having worked in GME for over 14 years, she is currently an Associate Director at the HonorHealth Family Medicine Residency where she oversees Geriatric training. She practices in the inpatient, outpatient, and long term care settings, and even does home visits with her resident physicians. She is passionate about seeing each patient as an individual who deserves care unique to who they are. Outside of medicine her life is filled with being a mom to her two daughters, hiking, painting, and spending time with her husband, family, and dogs. Dr. Travis Glenn's Bio: Dr. Travis Glenn and his husband Dr. Bradley Glenn are the physician founders of Glenn Family Medicine on the island of Maui, HI. His training started at the Georgia Institute of Technology followed by medical school at Ross University School of Medicine. He then moved to Arizona to complete residency at HonorHealth in Scottsdale. He previously worked as a hospitalist at Banner University's Phoenix campus, followed by a hybrid inpatient/ outpatient model in Hawaii before focusing on outpatient care and working with medical students from the University of Hawaii. When not in clinic he can usually be found exploring national parks or falling off his paddle board at the beach. 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. Gurus: Darlene Moyer, MD, Travis Glenn, MD Guest Host: Megan Teramoto, BS, MS Hosts: Patty Lee, MD, Sam Ing, MD Graphic Designer: Jai Daniels, BA Primary editor: Sam Ing, MD Peer reviewer: Sindhura Vallabhaneni, MD

#11: Dear Patients and Families: How to navigate dementia during the holidays with Tessa Garcia McEwen, AM, LCSW, DCCS, CDP

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. Guru: Tessa Garcia McEwen, AM, LCSW, DCCS, CDP Guest Host and Show Writer: Megan Teramoto, BS, MS Hosts: Patty Lee, MD, Sam Ing, MD Editor & Graphic Designer: Patty Lee, MD Host Bio: Tessa has over 20 years of experience supporting diverse populations in the nonprofit and medical sectors, focusing on personalized care and intergenerational connection. Currently at UChicago Medicine, she primarily supports patients and families dealing with Alzheimer's disease and related dementias. Through the Memory Center and consults across outpatient neurology and neurosurgery clinics. She's also a global facilitator for Lorenzo's House, co-leading programs for youth and care partners impacted by dementia. Also a recipient of the Schweitzer Fellowship, Tessa emphasizes grief support, cultural humility, and compassionate care in her work. She co founded Dementia Friendly Hyde Park she holds a BA in sociology from Notre Dame and a master's in clinical social work from the University of Chicago. Tessa's full bio here 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. Timestamps: 00:28 Introducing Our Special Guest: Tessa Garcia McEwen 02:14 Warm-Up Questions and Holiday Traditions 03:28 Navigating the Holidays with Dementia 07:39 Celebrating in Nursing Homes 09:52 Communicating Dementia Diagnosis to Family 15:20 Traveling with Dementia 18:52 Coping with Grief During the Holidays 23:13 Final Thoughts

#10: Hearing Loss with Joshua Sevier, AuD, LLM

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.

#9: Communicating about dementia: Diagnosis and Prognosis with Dr. Sing Palat

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. Guru: Sing Palat, MD Peer Reviewer: Elizabeth Zavala, MD Guest Host: Andrew Dang, MD Hosts: Patty Lee, MD, Sam Ing, MD Graphics designer: Jai Daniels Show notes writer: Patty Lee, MD

#8: Elder Abuse: When to Report, How to Report, and What Happens After with Annie Vernon-Cwik, LCSW, ASW-G

Elder abuse...who you gonna call???????? ADULT PROTECTIVE SERVICES IN YOUR STATE! Think you know what to do, how to report, and when to report? Think again! For no specific reason, we have tea time with Annie Vernon-Cwik, LCSW, ASW-G, to discuss. State specific reporting contacts Show Notes: https://verigeripodcast.com/show-notes Reference to episode 2 on dispo, safety, and independence in the older adult: Apple EP2 Spotify EP2 Timestamps 1:30 Annie's background in Adult Protective Services 2:44 What is Adult Protective Services and who do they serve? 3:38 How to report (in Illinois) 4:27 9 types of abuse 4:43 Physical abuse 5:00 Emotional abuse 5:26 Financial exploitation 5:57 Sexual abuse 7:38 Confinement 8:04 Passive neglect and willful deprivation 9:28 Abandonment 10:18 Self neglect 11:30 We are mandated reporters 12:43 How to report and what happens after a report is filed 14:10 What does reporting look like in a nursing home? 17:35 Cases 17:46 Case of a man with moderate dementia with significant weight loss and weakness and refusal of help 21:55 Case of a woman with dependence on daughter for medication 23:21 Case of a woman with anxiety and threat of being placed in a nursing home 26:18 Case of a woman who is worried about fraudulent credit card charges

#7: "Yes, and" - Management of behavioral symptoms in dementia with Dr. Erin Zahradnik and Carrie Jackson

Gurus: Erin Zahradnik, MD, Carrie Jackson Hosts: Patty Lee, MD, Sam Ing, MD Guest Host: Marissa Korte, MD A patient and family member come in stressed because of wandering/paranoia at home, and they need help! Time is ticking. What do you say? What are nonpharmacological interventions anyway? Does it live up to its character count? When and how do you use antipsychotics? What about THC? Also, some other things to add to the potpourri - what about THC and benzos? AHHHH!!!! In this episode, we talk with Dr. Zahradnik, a geriatric psychiatrist, for her advice, and with Carrie Jackson, who is a writer and was a caregiver for her father in her 20s as her mother was diagnosed with Parkinson's around the same time. Erin K. Zahradnik is an associate professor and director of geriatric psychiatry in the Department of Psychiatry at the University of Chicago Medical Center. She received her medical degree from University of Kansas School of Medicine, completed psychiatry residency at Yale-New Haven Hospital, and finished fellowship training in Geriatric Psychiatry and in Hospice and Palliative Medicine, both through the Icahn School of Medicine at Mount Sinai in NYC. Carrie Jackson is an Evanston-based freelance writer and communications specialist, with a focus on holistic health and fostering sustainable communities. Music and art fill her up, and she enjoys exploring Chicago's rich cultural offerings while also curating her own events. A year-round biker, you can find Carrie trekking around the world or getting lost in the great outdoors here at home. Connect at CarrieJacksonWrites.com. Show notes for summary and bonus tips!: https://verigeripodcast.com/show-notes/f/yes-and---management-of-behavioral-symptoms-in-dementia Timestamps 2:01 About Dr. Erin Zahradnik and Geriatric Psychiatry 2:57 What are behavioral symptoms anyway? 4:12: Introduction to Carrie Jackson, who was a caregiver for her dad with dementia 05:27 Comorbid mood disorders 07:09: How do you screen for comorbid mood disorder in people with dementia? 08:12: A case of dementia and agitation 10:15 Nonpharm treatment – what are the options & the clinician perspective 12:19 Nonpharm treatment – the caregiver perspective 17:25 When to use pharmacological treatment 17:50 SSRIs in mild dementia with comorbid anxiety and depression 19:17 Black box warning of antipsychotics 20:38 Antipsychotics: type, dosing, schedule 25:46 THC 28:52: Two bonus rounds 29:30 Case of delusions 34:29 Case of benzos

#6: Introduction to Hospice with Dr. Mohammed Ilyas Ahmed Khan

What is hospice? What is inpatient hospice? What happens when you press "discharge to hospice"? What are some pearls and pitfalls of communicating about hospice? Find out in this episode as Dr. Khan addresses misconceptions, myths, pearls and pitfalls, settings, a case of anoxic brain injury, and concepts on end of life management. 1:39 Introduction to the Guru 4:23 Origins of hospice 7:19 Taboos of hospice 8:39 What does comfort mean to you? 10:44 A Case of anoxic brain injury 15:22 Guiding communication 18:04 Pearls and Pitfalls 23:07 Where can the service of hospice be provided? 26:43 A little about payment 30:29 End of Life symptoms Guru: Mohammed Ilyas Ahmed Khan, MD Hosts: Patty Lee, MD, Sam Ing, MD Guest Host: James Fan, MD Editor: Sam Ing, MD Show Notes Editor: Marissa Korte, MD Peer Reviewer: Vasyl Hereha, MD Infographic Peer Reviewers: Vasyl Hereha, MD, and Jigar Joshi, MD

#5: Spicy (& Difficult) Situations with Dr. Mark Watson

Ever toss and turn after a goals of care meeting? Wondered when to consult ethics and palliative care? Had moral distress before, during, or after a family meeting in the dead of night after missing a meal and back-to-back pages? Have we got an episode for you! Join us as Dr. Mark Watson, a palliative care, hospice, and ethics expert, goes through the differences between a surrogate and a healthcare power of attorney (POA), and then we throw him into the deep end of increasingly difficult situations with more and more heat! How will he fare? Will us fellows continue to deeply breathe in the second stall of the bathroom with silent tears rolling after reliving the trauma of situations, mistakes, and disagreements in residency (this is not personal I swear)? Will Marissa, M4 now MD, be able to take the heat? FIND OUT! Show notes edited by Caroline Montag, BA: https://verigeripodcast.com/show-notes/f/spicy-difficult-situations-with-dr-mark-watson 0:40 Intro to our guru 0:57 Outline 1:53 Intro by Dr. Watson 3:04 Bread & Butter of surrogate versus healthcare power of attorney 3:36 Healthcare Power of Attorney (HCPOA) 5:51 Surrogate 8:25 What about the capacity of a surrogate or HCPOA? 11:08 Introduction of the challenges for Dr. Watson 11:45 Case 1: A patient with frailty, severe dementia, and full code 18:36: Case 2: Advance Care Planning says one thing about a feeding tube, but family wants another 25:02: Case 3: Asking about code status to a patient in distress 32:36: Case 4: An unbefriended patient 35:24: Case 5: Surrogate wants to reverse code status 39:31: BONUS: Hospice with Full Code 42:06: A brief summary and short motivational comments by Dr. Watson Guru: Dr. Mark Watson Hosts: Patty Lee, MD, Samantha Ing, MD, Marissa Korte, MD Editor: Patty Lee, MD Our Very Excellent Peer Reviewers: Melissa Marinelli, MD, Jason Lyou, MD Show Notes Editor: Caroline Montag, BA Theme Song: Samantha Ing and Patty Lee, mixed by Tak Ikuma Piano transitions: Patty Lee

#4: Goals Before Holes: Feeding & PEG tubes in dementia with Dr. Tia Kostas and Dr. Bharati Kochar

In this episode, we delve into the complexities of managing feeding difficulties in patients with advanced dementia. Dr. Kostas, a seasoned clinician in geriatric medicine, shares insights and strategies for counseling patients and families facing these challenging situations. Then, we'll turn to Dr. Kochar, a gastroenterologist with extensive experience in procedural medicine with a unique geriatric lens. She shares insights into the complexities of assessing patients for percutaneous endoscopic gastrostomy (PEG) tubes. Drawing from a case involving a 70-year-old patient with multiple comorbidities, Dr. Kochar, explores the nuanced considerations involved in deciding whether a PEG tube is appropriate in cases where it's not severe dementia. Check out the show notes for more nuggets of wisdom and quick links & references: https://verigeripodcast.com/show-notes/f/goals-before-holes Inspiration for episode: a question from Nicole Lum, MD Inspiration for episode title: Coined by Dr. Mark Watson and adopted by the Regional Palliative Fellows of Chicago 2023-2024 Gurus: Tia Kostas, MD, and Bharati Kochar, MD, MS Hosts and Co-Producers: Patty Lee, MD & Samantha Ing, MD Guest Host: Marissa Korte, MS Editor: Patty Lee, MD Peer reviewer: Katherine Thompson, MD Show notes creator: Marissa Korte, BS Faculty Mentor: Christopher Chiu, MD, FAAP, FACP Music: - Theme Song: Samantha Ing and Patty Lee, mixed by Takakuni Ikuma - Piano transitions and background: Patty Lee

#3: Diarrhea and Inflammatory Bowel Disease in the Older Adult with Dr. Bharati Kochar

Diarrhea. Abdominal pain. Weight loss. Patient might not be able to tolerate colonoscopy. What do you do?! Join us and Dr. Kochar as we go through the bread and butter of diarrhea and IBD and the "beyond" of an intersection between Geriatrics and GI. Check out the show notes for more nuggets of wisdom and quick links & references: https://verigeripodcast.com/show-notes/f/diarrhea-and-inflammatory-bowel-disease-in-the-older-adult 02:08 Introduction of Dr. Bharati Kochar 05:57 The Case 06:46 The Questions 09:05 IBS vs IBD 10:07 Microscopic colitis 10:38 Review 11:34 Scratching the surface on PPIs 13:30 Ddx 14:20 Workup 16:18 Flex sig? 17:45 What's a really red flag? 18:26 Coordinate care with GI 19:27 What if dx'd with IBD? 20:36 UC vs Crohn's 20:51 Treatments 21:57 What Geriatricians should know about IBD treatments 22:22 The 'Roids Guru: Bharati Kochar, MD, MS Hosts and Co-Producers: Patty Lee, MD & Samantha Ing, MD Editor: Patty Lee, MD Peer reviewers: Christopher Chiu, MD, FAAP, FACP, Antoinette Pusateri, MD Show notes creator: Marissa Korte, BS; edited by Antoinette Pusateri, MD Faculty Mentor: Christopher Chiu, MD, FAAP, FACP Music: - Theme Song: Samantha Ing and Patricia Lee, mixed by Takakuni Ikuma - Piano transitions and background: Piano by Patricia Lee

#2: Dispo, Independence, and Safety in Older Adults with Annie Vernon-Cwik, LCSW, ASW-G

"They can't live alone at home." "What's the discharge plan???" Ever meet the conundrum of providing the "right" support of an older adult at home trying to balance independence and safety? We speak with one of our star social workers, Annie Cwik-Vernon, LCSW, Advanced Social Worker in Gerontology (ASW-G), as she walks us through a difficult clinical situation, navigates different levels of care, and clarifies the selection of a decision maker. Check out the show notes for more info or the too-long-didn't-listen: https://verigeripodcast.com/show-notes/f/balancing-independence-and-safety-in-an-older-adult Timestamps: 01:29: Introduction of our guest 04:29: The case 06:50 Evaluating support in the house 08:10 Medication support 11:49 Finances and logistics for a caregiver 16:35 Different discharge locations 17:00 Assisted vs supportive living 20:04 Memory Care 23:54 Senior and independent living 28:23 How to assess for a decision maker 30:00 Illinois surrogacy act 35:46 We attempt to trap Annie in a legal guardianship scenario Edited by: Samantha Ing, MD Co-produced by: Patty Lee, MD, Samantha Ing, MD Show notes by: Marissa Korte, BS Music: - Theme Song: Samantha Ing and Patricia Lee, mixed by Takakuni Ikuma - Piano transitions and background: Piano by Patricia Lee