Palliative Rehab?!?: Ann Henshaw, Tamra Keeney, and Sarguni Singh

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GeriPal - A Geriatrics and Palliative Medicine Podcast 51 min 4 speakers 7 chapters transcribed 8 hours ago

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What is the purpose of this podcast and who are the featured guests?

Eric Widera 0:01

This episode of the Jerry Pal podcast is sponsored by something really near and dear to Alex and my heart, the UCSF's Division of Palliative Medicine. We have interviewed a lot of faculty from UCSF, from physicians like Steve Panellat, Mike Rabo, Cara Bishop, chaplains like Judy Long, and social workers like Bridget Sumpser. It is really an amazing group doing amazing, world-class palliative care, and they're looking for physician faculty to join them on the inpatient and outpatient setting.

Alex Smith 0:31

Yeah, the Division of Palliative Medicine at UCSF is a really well-established academic palliative care team. They have active educational and research efforts. They're truly interdisciplinary. They have a strong emphasis on diversity, equity, and inclusion. And they really prioritize sustainability and resilience of their faculty. If you're interested in learning more and applying, please go to palliativemedicine.ucsf.edu and click on the job openings tab or look at the link associated with the show notes for this episode.

Eric Widera 1:05

And you get to hang out with me and Alex. Welcome to the Jerry Pal podcast. This is Eric Guadera. This is Alex Smith. And Alex, who do we have with us today?

Alex Smith 1:16

Today, we are delighted to welcome Anne Henshaw, who brought this podcast idea to us. Dear listeners, if you have a podcast idea, feel free to reach out to us. Anne Henshaw is an occupational therapist who works clinically at Georgetown and teaches at GW. Anne, welcome to the Jerry Pal podcast.

Ann Henshaw 1:32

Thank you. Very excited to be here.

Alex Smith 1:34

And Tamara Keeney is a physical therapist and research scientist and director in the Division of Palliative Care at Massachusetts General Hospital and Harvard Medical School and is also a former JAGS junior reviewer. Tamara, welcome to the Jerry Powell podcast.

Tamra Keeney 1:47

Thanks for having me here.

Alex Smith 1:48

And Sarguni Singh, who's a hospitalist researcher, assistant professor of medicine in the Division of Hospital Medicine at the University of Colorado. Sarguni, welcome to Jerry Powell.

Sarguni Singh 1:58

Thank you. Excited to be here.

Alex Smith 2:01

And as a guest host today, Lynn Flint, who's been on many times, she's a palliative care doctor and director of our Jerry Pal Fellowship. Lynn, welcome back.

Lynn Flint 2:09

Thank you for the invitation.

Eric Widera 2:11

So we're going to be talking about palliative rehabilitation or really the intersection between palliative care and rehabilitation. But before we go into that subject, Anne, I think you have a song request for Alex.

Ann Henshaw 2:23

I definitely do. Sweet Caroline.

Eric Widera 2:26

Anne, why did you choose Sweet Caroline?

Ann Henshaw 2:28

Well, you know, I think teamwork is key in this space and I'm a big baseball fan, big Red Sox fan, which is not a big, good thing to be right now. But I really think it's indicative of how we should all be working together on this team to help our seriously ill patients.

Eric Widera 2:43

And probably Alex, as you didn't have to twist Alex's arm for a Neil Diamond.

Ann Henshaw 2:49

No, he was very excited.

Alex Smith 2:51

We have done this one before, but we're going to do it again. And this time everybody's joining in. Here we go. Where it began I can't begin to know when But then I know it's going strong Was in the spring Then spring became a summer I would have believed you'd come along Hands, touching hands, reaching out, touching me. Touching you Sweet Caroline Good times never felt so good I'd be inclined To believe they never would

Ann Henshaw 4:11

Great

Alex Smith 4:12

job.

Ann Henshaw 4:14

Love it. I'm

Alex Smith 4:15

Ann Henshaw 4:15

the mood for ball

Alex Smith 4:15

games. Perfect in every way. Perfectly synced. Yes.

Lynn Flint 4:21

Thank you. We all have our red Dixie cups down here. I'm at Fenway.

Eric Widera 4:29

I was telling Alex today when he said that we were going to sing, I'm all, Neil Diamond is the one song, group of songs I can sing, but I usually have to have several beers in me. Yes. That's right.

Lynn Flint 4:41

We did not have any beers today at work. Dear listeners.

Eric Widera 4:48

So, Anne, thank you for requesting this podcast. I'm wondering, I think we're now close to 300 podcasts. Why did you push for this podcast, Anne?

Ann Henshaw 4:59

You know, I guess I've been a clinician for almost 40 years, believe it or not. But really, I think that the impetus for this is personal. You know, I lost my brother at age 46 and within a five year period had a bunch of other loss.

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Chapters

7 chapters

1 What is the purpose of this podcast and who are the featured guests? 0:01–7:50 2 Why did Anne Henshaw want to start a podcast about palliative rehabilitation? 7:50–15:44 3 How did a real‑time family meeting illustrate the dilemma of SNF rehab versus hospice? 15:44–25:29 4 What evidence exists on outcomes of rehabilitation for patients with advanced cancer? 25:29–33:36 5 Why do physical therapists feel their role is limited to discharge planning and how can it expand? 33:36–41:35 6 How can clinicians improve communication and collaboration between rehab and palliative care teams? 41:35–47:20 7 What tools or prognostic models are available to predict functional recovery after rehab? 47:20–51:02

Speakers

4 identified

Sarguni Singh 8 min Eric Widera 6 min Alex Smith 6 min Lynn Flint 3 min

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Topics in this episode

Alex Smith 2 Harvard Medical School 1 Ed Martin 1 Massachusetts General Hospital 1 Susan Nelson 1 Georgetown 1 University of Colorado 1 Christopher Heck 1 Mark Wren 1 Lynn Flint 2 Jerry Pal 1 UCSF Division of Palliative Medicine 2

Source

Recorded26 Oct 2023

Publisherrss.libsyn.com ↗

Transcriptspeaker-named · 100+ languages

Handlerec:20524578

Show notes

Often podcasts meet clinical reality. That's why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. But rarely does the podcast and clinical reality meet in the same day. Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. Physical therapy had walked with him that day and noted improvement compared to previous walks, suggesting that he should be discharged to a skilled nursing facility for rehabilitation on discharge. The patient's capacity to make decisions was marginal, and his sons were shouldering much of the responsibility. The sons were very focused on rehabilitation, and the patient gave his assent. In the meeting, I used the language suggested by Sarguni Singh, "I worry that going to SNF for rehab may not result in your being independent." We additionally discussed hospice care as an option for care that might follow the trial of rehabilitation. Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Lynn Flint, author of the NEJM perspective titled, "Rehabbed to Death," joins Eric and I as co-host. We cover a lot of ground in this podcast, including an evidence based toolkit to promote collaboration between therapy fields and palliative care, outcomes of rehabilitation for people with advanced cancer (hint: not much hospice, lots of re-hospitalization), and a JAGS study on use of post-acute care among patients with heart failure. We also heard from Tamra about her opinion piece in which she laments, "The role of rehabilitation is often myopically constrained to facilitation of efficient discharge planning." Therapists are so much more. At the end of the day, I lamented that physical, occupational, and speech therapists aren't more tightly integrated with palliative care teams. As Lynn says at the end of the podcast, to paraphrase, "Physical therapy, occupational therapy, speech therapy - all this therapy for older frail patients is a core part of good palliative care." And our guests sing along with "Sweet Caroline" - so good, so good, so good! -@AlexSmithMD This episode of the GeriPal Podcast is sponsored by UCSF's Division of Palliative Medicine, an amazing group doing world class palliative care. They are looking for physician faculty to join them in the inpatient and outpatient setting. To learn more about job opportunities, please click here: https://palliativemedicine.ucsf.edu/job-openings

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