show episodes
 
Educating at every step. Absolute Trust Talk is not your run of the mill general counsel show filled with legal jargon that doesn’t resonate. Through her 20+ years of practice, Absolute Trust Counsel managing attorney Kirsten Howe found herself working with clients who were confused and overwhelmed by the complexity of estate planning and saw a need to help clients with education and specific client-centered estate planning services. Now Kirsten is taking her expertise and experience to a ne ...
 
A geriatrics and palliative care podcast for every health care professional. We invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. You'll laugh, learn and maybe sing along. Hosted by Eric Widera and Alex Smith.
 
Welcome to the SmartLinx Podcast! Each podcast runs about 10 to 20 minutes in length and covers topics ranging from human resources to compliance, scheduling, recruiting, payroll and more. Our own Darcy Grabenstein interviews subject matter experts, both internal and external, to provide you with actionable insights. And now, on to today’s podcast!
 
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show series
 
One of our earliest COVID podcasts with Jim Wright and David Grabowski a year ago addressed the early devastating impact of COVID on nursing homes. One year ago Mike Wasserman, geriatrician and immediate past president of the California Long Term Care Association, said we’d have a quarter million deaths in long term care. A quarter of a million dea…
 
Unfortunately, many today see money as a solution to problems, but that is not always the case. In fact, wealth can be quite damaging to a family dynamic. Planning, in this instance, is vital. When family members have prepared and have learned how to work together, that’s when wealth and inheritance can be used as a tool to benefit a family for gen…
 
COVID has taken a devastated toll in nursing homes. Despite representing fewer than 5% of the total US events, at least 40% of COVID‐19–related deaths occurred in older individuals living in nursing homes. The good news is that with the introduction of COVID vaccines in nursing homes, numbers of infections and outbreaks have plummeted. However, onl…
 
There are many great options these days when it comes to senior living communities and long-term care, but that's just it. There are hundreds of options. Finding the best solution for yourself or a loved one is a project and can be a daunting task for families. How do you truly know what the best choice is for elderly parents? In a new episode of A…
 
Hospice may not be a great match for all of the care needs of people with dementia, but it sure does help. And, as often happens, when patients with dementia do not decline as expected, they are too frequently discharged from hospice, an experience that Lauren Hunt and Krista Harrison refer to in an editorial in the Journal of the American Geriatri…
 
As family members age, we often find other members becoming involved in caregiving and decision-making. Unfortunately, this can sometimes lead to conflict as communication and relationships deteriorate in disagreement over an issue that impacts the older adult or the family as a whole. In these cases, it can be helpful to have a qualified third par…
 
The COVID pandemic brought to light many things, including how society views older adults. Louise Aronson wrote a piece in the NY Times titled “‘Covid-19 Kills Only Old People.’ Only? Why are we OK with old people dying?”. The ageist viewpoint she was rallying against was also brought to light in a study of ageism in social media. When looking at t…
 
So what exactly does a hospice medical director do? Why do some choose to become hospice physicians? What additional training is needed, if any, beyond Hospice and Palliative Medicine fellowship and boards? Who should take the new Hospice Medical Director Certification Board Examination? A recent study in JAGS found high rates of hospice disenrollm…
 
If you have minor children, nominating a guardian for them in case of your death or incapacity is one of the most important reasons to do an estate plan. For many families, the choice is not easy, and they end up procrastinating. Think of it this way, do you want a judge, who may know nothing about your children or your family, deciding who your ch…
 
Where are we with Alzheimers? Are we about to see a revolution in how we diagnose and treat it with Amyloid PET scans and the amyloid antibody aducanumab (which is currently on FDA’s desk for approval)? Or are we still in the same place where there is no meaningfully effective treatment? Or is it somewhere in between, given the data that we have on…
 
Because the federal estate tax exemption is so high, currently set to $11,700,000, many people believe their families won’t have to worry about filing a federal estate tax return (IRS Form 706) on their deaths. And while this may be true to a certain extent, there are also benefits that come with filing an estate tax return that could save your fam…
 
Nursing home residents have been devastated by COVID. Somewhere around 40% of deaths from COVID have been among nursing home residents, though they make up just a sliver of the US population. Prognostication among nursing home residents who have COVID is important for a host of reasons - for counseling patients and families about what to expect, fo…
 
Unfortunately, there comes the point in life when the family home becomes a burden, whether that is emotionally, physically, or financially. And, usually, downsizing might seem like the way to go, but it doesn’t come without complications. There is so much more to moving and downsizing in the aging journey. It’s not just about buying and selling a …
 
Proposition 19 is a ballot measure passed in the November 2020 election in the state of California that significantly changes the property taxes on real estate inherited by children from their parents. And not in a good way. Under this proposition, a parent can only transfer the primary residence (either by gift, by inheritance or by sale) without …
 
Lesbian, gay, bisexual and transgender (LGBT) older adults have lived through a lifetime of discrimination, social stigma, prejudice, and marginalization. Is the care that we are giving them in later life changing any of that or are we pushing them back into the closet? This is what we talk about in this week's podcast with Carey Candrian from the …
 
On the one hand, every year we are fortunate to have new medications that help older adults and people living with serious illness. New treatments for lung cancer with remarkable survival outcomes come to mind, for example. On the other hand, the tremendous growth in medications has led to an explosion of prescribing, polypharmacy, with attendant s…
 
Most of us know we are going to die. How often though do we actually let ourselves really internalize that understanding? To imagine it? To feel it? To try to accept it? On today’s podcast we invited BJ Miller back on our podcast to talk about death using as our guide his recent NY Times editorial What Is Death? How the pandemic is changing our und…
 
In the past, reverse mortgages have had a negative connotation associated with them due to high fees and a lack of understanding of what they were and why they are being purchased. Nowadays, we see a rise in popularity among older adults and seniors who have equity in their homes and want to help supplement their income. In a new episode of Absolut…
 
Many of us in geriatrics and palliative care assume that we are the experts in health care when it comes to understanding the caregiver experience. Every once in a while, we are humbled and reminded of what we don’t know. Jessica Zitter had such an experience. Jessica, as many of you know, is an award winning author (link to our podcast about her b…
 
When it comes to planning for a young family, whether it is financial or estate planning, it’s never too early to get started. Typically, young families share the same concerns and characteristics. It can be hard to navigate all the tools, information, and strategies that are out there. Many may put planning off or choose a route, not knowing if it…
 
Surrogate decision‐making around life-sustaining treatments in the hospital even in the best of circumstances is hard. It’s maybe even harder when caring for those who are conserved or have a professional guardian. The conservator may not have known the patient prior to them losing capacity, they may not know their values or goals that can help gui…
 
“Diagnose and adios.” That’s the sad phrase that I’ve heard quoted more than once, representing caregivers' sentiment of what it’s like to be told by a clinician that your loved one has dementia. This week we talked with Zaldy Tan, Geriatrician and Director of the Memory and Aging program at Cedars Sinai in Los Angeles. With David Reuben at UCLA an…
 
When it comes to life insurance, most of us think of it as a death benefit when someone dies too soon. However, when used strategically, it can do so much more. In estate and retirement planning, it can be used as a complementary financial tool to help you meet specific goals or help secure financial protection. In a new episode of Absolute Trust T…
 
What does it mean to create a cultural shift to the end of life experience? Is it even possible? How do you even start something like that? On today's podcast, we talk to Shoshana Ungerleider about her experience making that change. Shoshana is one of those amazing advocates for palliative and end of life care. She started the Ungerleider Palliativ…
 
How long does it take to see a benefit of statin therapy for primary prevention of cardiovascular events in adults aged 50 to 75 years? That's the question we try to answer with our two guests today, Drs Lindsey Yourman and Sei Lee, the lead and senior author of a JAMA IM study that tried to answer this question. In this podcast Drs. Yourman and Le…
 
Taking over control of finances and your financial future can be overwhelming, especially for women who may be experiencing divorce, a spouse's death, or another major life event. However, it can be done smoothly and with peace of mind. In a new episode of Absolute Trust Talk LIVE, Kirsten welcomes guest Mary Ballin. Mary is a Certified Financial P…
 
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, …
 
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 inform…
 
Fraudulent schemes aren’t uncommon, especially among our senior populations. Since COVID began, we’ve seen a few interesting twists pop up. Scammers have become even more creative at seizing opportunities as they arise. That’s why it is vital to take the necessary steps to protect yourself, your loved ones, and your assets. In a new episode of Abso…
 
In this week's podcast we talk with Kieran Quinn, author of a systematic review and meta-analysis of palliative care for non-cancer illness, published in JAMA. We also talk with Krista Harrison, first author of an accompanying editorial. JAMA editors cut out some of my favorite parts of Krista's editorial, possibly because they were more like a blo…
 
There are a lot of large numbers that involve heart failure, starting with the sheer number of patients diagnosed (6.5 million and counting), to the cost of their care (~$70 billion by 2030), to the amount of money invested by the NIH into research ($1 billion annually). But the smaller numbers deserve attention too - 50% of patients die within 5 y…
 
It's easy to say, "when disaster strikes, be prepared," but how easy is it to move hundreds or thousands of long-term care residents when a fire or flood is bearing down on a facility? How do you know a family member will be safe and taken care of? The good news is that facilities are required to have an emergency plan in place, but we also need to…
 
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…
 
Last month we published a podcast with Sean Morrison that garnered a great deal of attention, in which Sean Morrison argued that Advance Care Planning is an idea that is “clear, simple, and wrong.” This week, we have a fresh updated counterpoint from Rebecca Sudore and Ryan McMahan. These two published a paper this week in the Journal of the Americ…
 
Estate planning is an interesting topic, usually because most people immediately think we're talking about planning for their death. But what happens if you are unable to make decisions for yourself? Incapacity planning is one of the most critical planning strategies you can implement because things can be challenging for your family without it. In…
 
In 1968 a committee at Harvard Medical School met to lay down the groundwork for a new definition of death, one that was no longer confined to the irreversible cessation of cardiopulmonary function but a new concept based on neurological criteria. Over the next 50 years, the debate over the concept of brain death has never really gone away. Rather …
 
Chris Callahan (of Indiana University) and Lee Jennings (University of Oklahoma) have some righteous anger. Why do we have comprehensive cancer care centers and not comprehensive dementia care centers? We have a body of evidence dating back 30 years to support people with dementia and their caregivers with Comprehensive Dementia Care. Lee Jennings …
 
Every year, about a third of older adults fall. About one in five of those falls result in moderate to severe injury. What can we do to help not only prevent those falls but also the complications of them? On todays podcast, we talk to Tom Gill, one of the authors of the recent Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE)…
 
No dear listeners and readers, that is not a typo. Eric Widera is indeed our guest today to discuss his first author publication in the New England Journal of Medicine, Family Meetings on Behalf of Patients with Serious Illness. Our other guests include other authors James Frank, Wendy Anderson, Lekshmi Santhosh, me and actress and frequent GeriPal…
 
The elder care journey is called a journey for a reason. It’s not linear, and many times people won’t know what will happen to them as they age. And while it is hard to predict, it’s not impossible to plan for, but it is essential to recognize that the type of care needed and how that care is paid for is a large part of the journey to help an older…
 
COVID-19 has created a perfect storm in nursing homes. As noted in a recent Journal of the American Geriatrics Society (JAGS) article by Joe Ouslander and David Grabowski, the storm is created by the confluence risks, including a vulnerable population that develop atypical presentations of COVID-19, staffing shortages due to viral infection, inadeq…
 
Sean Morrison dropped a bomb. It's a perspective I've heard before from outside of palliative care, most clearly by bioethicists Angie Fagerlin and Carl Schnieder in their landmark article Enough: The Failure of the Living Will. But Sean Morrison, Director of the National Palliative Care Research Center and Chair of the Department of Geriatrics and…
 
For any business owner who’s taken a PPP Loan, you know exactly how challenging the application process was. Now that you may be looking to get that loan forgiven, unfortunately, the forgiveness application isn’t any less challenging or confusing. On top of that, if you don’t apply correctly, you will have to pay all the money back. In a new episod…
 
Reasons to move out of California, or if you’re thinking more local, out of the Bay Area, may range from a lower cost of living, lower taxes, less crowding, retirement, following family, or simply a change of pace. But it’s no secret that the extensive list of things that need to be done for moving can be overwhelming. How do you start? Where do yo…
 
In this week's GeriPal podcast we talk with Louise Aronson, author of the Pulitzer prize finalist Elderhood (https://www.amazon.com/Elderhood-Redefining-Transforming-Medicine-Reimagining/dp/1620405466). Louise has been one of the (sadly) few voices beating a loud and urgent drum in the medical and lay press about the insidious ageism taking place i…
 
Being named as the executor or trustee of an estate is a big job. There are many tasks and responsibilities to take care of. And on top of that, it’s hard to imagine being able to make these important financial and legal decisions while grieving. A lot of times, people have no idea where to start or what to do. Without basic knowledge of the trust …
 
Individuals with special needs and their families face unique challenges when it comes to living, working, and even participating in their community, but it doesn’t mean that they can’t find independence. In a new episode of Absolute Trust Talk Live, Executive Director of East Bay Innovations, Tom Heinz joins Kirsten to discuss his organization and…
 
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