Rethinking Advance Care Planning: A Podcast with Rebecca Sudore
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
37 min
4 speakers
8 chapters
transcribed 3 days ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the purpose of this episode and who is the guest?
Welcome to the GeriPal podcast. This is Eric Widera. This
is Alex
Smith. And Alex, I see somebody else is in the room with us today.
Today we have a repeat guest. She's waving for the camera. We're on YouTube again. Hello, everybody. We have Rebecca Sidori, who is a professor of medicine here in the Division of Geriatrics at UCSF. And she's going to come talk to us today about another PREPARE trial, this time in Espanol.
So we're going to do all about advanced care planning. But before we do that, Rebecca, we ask all of our guests, do you have a song for Alex?
I do. Alex.
I've heard from your team that they wanted a song in Spanish, right? So, Gracias a la Vida. And this is in Spanish. I did take some Spanish at some point. High school. It's a little... Let's see how we do here. And we're only going to speak in Spanish from now on. Desde este momento, solamente, Harry
Pall en Español. Harry Pall. Gracias a la vida que me ha dado tanto me dio de luceros Que cuando los abro Perfecto distingo Lo negro del blanco Y en alto cielo Su fondo estrellado Y en las multitudes La mujer que yo amo Oh, that was fun. That was awesome. Yay. That was great.
So I'm guessing there was a reason we're doing something in Spanish today. And I think that's the reason. Rebecca, you have an article that was just published. Is that right?
That's right. It's very exciting.
on your Prepare for Your Care website and advanced care planning. So I'm hoping that we can chat a little bit about that. But before that, I'm wondering if we can take some big steps back, because really a national, international expert on advanced care planning. And I quite haven't figured out exactly when we talk about advanced care planning, like what are we actually talking about when we mention those three words together?
Yeah, well, it's very interesting because I think that the definition has evolved over time. I think when I started this work, advanced care planning really meant only one thing. Did you complete an advanced directive? And specifically, did you complete one of the checkboxes about CPR or mechanical ventilation? And I think to this day, people still think of advanced care planning as only that very small thing. So Terry Fried and I, in 2010, in Annals of Internal Medicine, published this paper called Redefining the Planning in Advanced Care Planning, which we really took a step back to try to broaden that definition because advanced care planning actually is many things. It's thinking about what is most important to you.
It's trying to identify your wishes and how you want to live your life and what brings your life meaning. And then communicating that to other people, either by having discussions or for some people, documenting them. So again, advanced care planning is very broad.
So it's not just if your heart were to stop, would you like us to restart it with electricity?
Much
broader than that. Much broader than that. And it's more than having a living will, durable power of attorney?
Exactly. It's a part of it. And I think as we were talking earlier, when we think about the field of palliative care, hospice is a part of that, but it isn't all of it. When you think about VIN diagrams, those advanced directives are a part of a much larger, broader process.
Right.
Why did the hosts sing a Spanish song and what does it signal for the discussion?
And when we're thinking about advanced care planning, you said the word process. And it sounds like that's a key part of it. This isn't a one-time thing. Like we had the discussion, we're done. Could you say more about that?
Yeah. So Terry Freed has done a lot of work thinking about readiness and things like that for people who are ready to engage in advanced care planning. And I think we found the same thing just like for, say, smoking cessation or getting engaged in an exercise program. People think about things for a while, they prepare, and then they're actually ready for action. And it's the same thing with advanced care planning. You know, I like to sort of think about, you know, the idea that you're not just going to sort of hit the double diamond, like run on your first time on a set of skis.
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Chapters
8 chapters
1
What is the purpose of this episode and who is the guest?
0:00–4:14
2
Why did the hosts sing a Spanish song and what does it signal for the discussion?
4:14–9:04
3
How do the hosts define advanced care planning beyond a simple advance directive?
9:04–13:22
4
What were the key findings of the original VA PREPARE trial?
13:22–17:57
5
How was the new PREPARE‑2 trial designed for English‑ and Spanish‑speaking patients in a safety‑net hospital?
17:57–23:28
6
What were the engagement and documentation outcomes of the PREPARE‑2 study?
23:28–28:41
7
How can clinicians implement PREPARE tools in primary or geriatrics practice?
28:41–33:22
8
What are the next steps, future directions, and where can listeners find the published article?
33:22–37:34
Speakers
4 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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