on television, CPR works about 70% of the time

March 26, 2024 11:29 AM

GeriPal podcast has over 300 episodes on geriatrics, hospice, and palliative care (with transcripts!) that are accessible to the layperson and feature a wide range of interviewees. One standout episode is The Language of Serious Illness with Sunita Puri, Bob Arnold, and Jacqueline Kruser: "[doctors] just offer options without context. And given that the culture of medicine is always to do more, the context will always push people to try something."

Other episodes to listen/read: Dignity at the End of Life: Time to Stop Driving; Variability in Care of Nursing Home Residents with Advanced Dementia.

posted by spamandkimchi (6 comments total)

Oh man these transcripts are great! Nursing school usually starts clinical rotations in long term care facilities/nursing homes and I believe as I was leaving the building the first day I texted my parents that they would never end up in one. I look forward to diving into this podcast more.
posted by lizjohn at 1:40 PM on March 26

From Dignity at the End of Life episode
. . . and he said, “I’m a really busy neurosurgeon, so whatever you’re going to suggest, better not take too much time.”
And so I said, “Well, how about this? What do I need to know about you as a person to take the best care of you possible?” And he paused for a few seconds and said, “Yeah, I think I can do that.” So we have introduced something that we’ve called the Patient Dignity question, which reads, what do I need to know about you as a person to take the best care of you possible?

That will get close to the self-image that the dying wish to project which their data say is key to "now I'm easy"
posted by BobTheScientist at 3:47 PM on March 26 [3 favorites]

This is awry in my wheelhouse alas.
posted by y2karl at 7:32 PM on March 26 [1 favorite]

I just finished reading the transcript for the Dignity at End of Life episode. I am particularly taken with the idea of balancing the need to provide the mechanics of care in a very overtaxed health care system with the need to provide dignified care. The two do not always go together. But when he says that the tone of care is as important as the time of care, yeah I can see that. I spent a harrowing amount of time advocating for a loved one who was un/semiconscious and at the end of her life, and I definitely recall the tone of the health care providers I interacted with. The best were able to communicate to me that they were doing their very best to make sure my loved one would receive the care she needed while she was so vulnerable. I remember a doctor, a resident, and a nurse who really had that down and understood what that desire for dignity in her last days entailed.
posted by hurdy gurdy girl at 8:22 PM on March 26 [4 favorites]

Another episode I really liked:
Surgical communication

On the one side, you can have a clinician who really uses a lot of fix-it language and everything is tacitly conveying that we’re going to get on with things and repair this and move forward, and the other side where, “Okay, let’s try to step back and deliberate.

And I do worry that surgeons can get very singularly focused on the lesion. And when they talk to patients and families, it’s a pretty easy sell. This is broken, and I have this thing that will fix it.

...

The problem is, that’s actually not a very good narrative for nearly everything we take care of in healthcare. It’s awesome for a femur fracture, maybe it’s great for appendicitis, but it is not great if you are a vascular surgeon because, yes, I can go around the blockage, but I am not changing your vascular disease or your multiple comorbidities, and I’m really saying absolutely nothing about whether I may or may not help your life.

posted by spamandkimchi at 9:51 AM on March 27 [1 favorite]

Also now that my parents are having more mobility difficulties, these two episodes were illuminating:
Intervention to reduce falls in the home
Disability in the home
posted by spamandkimchi at 9:53 AM on March 27 [1 favorite]