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C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative
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Creative Arts in Medicine
Connecting with Patients
Passion in the Medical Profession
Lifelong Learning in Clinical Excellence
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August 28, 2018 | 4 min read

6 things you need to know about geriatric psychiatry

By Susan Lehmann, MD, Johns Hopkins Medicine

In older adults, as in younger people, poor mental health undermines general health, quality of life, and overall functioning. Given the dearth of specialty-trained geriatric psychiatrists and geriatricians, it is crucial for all clinicians to have skills in the diagnosis and management of common mental health conditions affecting older adults.

April 17, 2019 | <1 min read

Dr. Ilene Browner, A CLOSLER Look

By Gretchen Miller, Managing Editor

Dr. Ilene Browner highlights the importance of learning and understanding her patients' hopes and goals of care.

August 27, 2019 | 3 min read

Letting the Laughter In

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

Excellent clinicians know that laughter can be a powerful tool in enhancing communication and building trust, particularly when working with older patients.

June 23, 2021 | 6 min read

Aducanumab: The Clinical Wisdom of Being Conservative, Careful, And Transparent

By Constantine Lyketsos, MD, Johns Hopkins Medicine

Clinicians frequently face thorny ethical dilemmas when caring for patients. Take time to reflect on all components of these issues before discussions with patients.

A patient's Maine coon kitten, pug puppy, and knitting project.

September 14, 2020 | 3 min read

The Unexpected Benefits of Seeing Patients Virtually

By Susan Lehmann, MD, Johns Hopkins Medicine

Telemedicine allows patients and clinicians to see and respond to each other’s facial expressions. Plus, clinicians are offered deeper insight into their patient’s world.

November 19, 2019 | 2 min read

Aging Isn’t a Dirty Word

By Sharon Inouye, MD, MPH, Encore Public Voices Fellowship, and Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

October 8, 2019 | 4 min read

Can you hear me now?

By Mariah Robertson, MD, Johns Hopkins Medicine

The onus may be on the clinically excellent doctor to overcome a the patient's disability that interferes with care. A pocket talker can make a big difference for patients with hearing impairment.

June 25, 2025 | 4 min read

Who’s visited you? 

The presence of loved ones at the bedside can anchor and orient older patients. In their absence, the medical team should collaborate thoughtfully with the interprofessional team to provide social and emotional support. 

June 23, 2025 | 2 min read

Your brain on vaccines 

Prioritize talking with patients about how vaccines not only prevent infection but support cognitive health. This is one way that patients can take steps to preserve brain function. 

August 9, 2018 | 4 min read

Becoming a better ally

By Mariah Robertson, MD, Johns Hopkins Medicine

LGBTQ seniors are at a significantly higher risk for health disparities and frequently withhold their gender identity or sexual orientation from their physician due to fear of being turned away or discriminated against. It is up to each of us to educate ourselves so we can be empowered to routinely ask about the sexual health of our aging patients.

Vibraphone. Copyright Chris Dingman.

December 5, 2019 | 2 min read

Peace—Music to Live

By Chris Dingman, vibraphonist and composer

Music with intention and sensitivity can be a powerful tool for helping the terminally ill—and others—cope with physical and emotional pain in order to find peace. Recommending this form of therapy to patients can be a valuable gift.

January 4, 2023 | 2 min read

Intergenerational Connections

By Susan Lehmann, MD, Johns Hopkins Medicine

We can benefit from relationships with those of different ages. Encourage patients to consider joining a community group with people from across generations. 

The stunning Mona "Moe" Driggs at the Boston Harbor Hotel, October 2010. Author's family photo.

November 21, 2019 | 2 min read

The Chosen One

By Ryan Chippendale, MD, Boston University School of Medicine

As a geriatrician, it was still difficult to facilitate compasstionate patient-centered end-of-life care for my grandmother. Honoring patients' goals of care can be challenging when we are intimately invested.

December 13, 2022 | 3 min read

Mindful Movement

By Ken Koon Wong, MD, Cleveland Clinic

Consider encouraging your patients to practice tai chi to reduce feelings of anxiety and promote relaxation.  

November 12, 2019 | 2 min read

The Early Bird Special

By Rebecca Hamburger, Medical Student, Central Michgan University College of Medicine

Timing is everything. Doing our best to optimize access to healthcare is a first step to serving our patients.

July 12, 2022 | 1 min read

When I Doubted my Patient

By Mengyi "Zed" Zha, MD, Othello, Washington

When patients are labeled as “poor historians,” it implies that they’re not to be trusted.

The author and her husband dancing to live music at their wedding. Photo courtesy of the author.

June 25, 2019 | 3 min read

The Shared Experience

By Mariah Robertson, MD, Johns Hopkins Medicine

Part of my history-taking in the future will include a music history to better understand the role music plays in my patient’s day-to-day lives. I am hopeful that this added information about them will strengthen our connection and understanding of one another as humans.

July 7, 2022 | 1 min read

Filial Affection

By Corliss Wong, MS4, The University of Hong Kong

We must listen closely to patients with dementia’s thoughts and feelings, even though their sense of reality may be different than our own.

April 24, 2019 | <1 min read

Dr. Colleen Christmas, A CLOSLER Look

By Gretchen Miller, Managing Editor

Watch a three minute video interview with Dr. Colleen Christmas, who shares the contagious joy of both primary care and geriatrics. Guaranteed to make you smile!

July 5, 2022 | 2 min read

Dementia, Decisions, And Developing a Different Love 

By Drea Burbank, MD, Putumayo, Colombia

We must be respectful and balanced when presenting medical options to a patient’s caregivers. 

February 21, 2019 | 1 min read

Substance Use Disorders in Later Life

By Mike Fingerhood, MD, Johns Hopkins Medicine

Substance use disorders in older adults often go undiagnosed because screening is frequently overlooked. Key to supporting patients to make a change is developing rapport and trust.

April 27, 2022 | 2 min read

Listening to Your Patient’s Grief

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

By listening to a patient’s story of loss, we bear witness and affirm their experience. 

Jeremy and the author out for a bike ride.

July 8, 2025 | 2 min read

Walking the road with Jeremy 

By constantly challenging me to connect my decisions back to the patient’s real needs, Dr. Walston pushed me to become a more thoughtful and compassionate clinician-scientist, always grounding my care and research in what matters most to those I serve. 

January 26, 2022 | 1 min read

Talking With Older Patients About Winter Hazards

By Shaista Ahmed, MBBS, MPH, Johns Hopkins Medicine

Be sure your geriatric patients are aware of winter hazards and provide guidance on how to avoid the risk of falls and hypothermia.    

July 1, 2025 | 3 min read

Dancing back to himself 

Caring for patients with delirium requires coordinated medical management—like early mobilization, minimizing sedation, and consistent re-orientation. Integrating familiar activities, like listening to music, may aid their recovery. 

December 15, 2021 | 1 min read

The Power of Humor

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My dying patient taught me that laughter can sometimes normalize difficult situations. Finding humor in the problem lightened the mood and allowed us to devise a care plan that preserved her dignity.  

June 18, 2025 | 1 min read

Lewy-body diary 

This poem describes the profound loss of autonomy experienced by patients with dementia. It’s a call to truly see the person grappling with the reality of their diminishing faculties. 

December 7, 2021 | 3 min read

A Window Into a Patient’s World

By Deirdre Johnston, MBBCh, MD, Johns Hopkins Medicine

Visiting a patient’s home environment, either virtually or in person, may shed light on the source of their distress.

May 29, 2025 | 2 min read

From code status to core values 

Advanced care planning is more than just a conversation about code status. Engaging in a comprehensive discussion about what matters most to the patient should guide preferences for future care. 

November 10, 2021 | 5 min read

Reading Between The Lines

We don’t always say what we’re thinking, particularly in difficult conversations. Sharing and exploring unspoken thoughts can lead to stronger connections with our patients and better care.

September 26, 2018 | <1 min read

Dr. Susan Lehmann: A CLOSLER Look

By Gretchen Miller, Managing Editor

Enjoy a three-minute video interview with Dr. Susan Lehmann, who shares how playing the piano helped her become adept at listening to patients while maintaining eye contact and writing notes.

October 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

May 8, 2025 | 2 min read

Lifting the resistance to strength training

Encouraging patients, especially older adults, to engage in strength training is often overlooked. Specific advice about the how and why can significantly improve uptake and may bolster their quality of life. 

Encourage caregivers to get support.

September 8, 2021 | 2 min read

How to Mitigate Caregiver Burnout

By Simone Lescott, MD, Johns Hopkins Medicine

Caring for a loved one can be emotionally exhausting. Remind caregivers to prioritize self-care and encourage them to seek support from others.

April 30, 2025 | 2 min read

Aging and autonomy 

Many older patients struggle with losing independence. Healthcare professionals can partner with them and their loved ones to ease challenging transitions. 

June 30, 2021 | 2 min read

Promoting Wellness Through Intergenerational Connections

By Susan Lehmann, MD, Johns Hopkins Medicine

Bridging the generations can enhance emotional well-being for young and old. Encourage patients to reach out to older family members and neighbors!

January 23, 2025 | 1 min read

Only 13.9%?! 

By Edward Slipek, MD, St. Paul, Minnesota

Every patient encounter provides an opportunity to have a conversation about their physical activity levels—recognizing its profound impact on both mental and physical health outcomes. 

April 22, 2021 | 2 min read

Making Condolence Calls

By Maria Carney, MD, Northwell Health, New York

When a patient dies, reaching out to the family can help them with closure. It may also be beneficial for clinicians.

January 7, 2025 | 3 min read

“Hope is the thing with feathers” 

By Karen Abernathy, CRNP, MSN, Johns Hopkins Medicine

By acknowledging patient emotions and actively listening without judgement, clinicians can improve communication barriers. This can build trust and may be especially important for those who are resistant to our care recommendations. 

Photo of Colin. Copyright with the family.

April 13, 2021 | 2 min read

Patient as Educator

By David Reid, Co-Director, Dare Dementia, England

From my patient with dementia, I learned that patients are experts on the lived experience of their illness. We must value and acknowledge their insights and be open to learning from them.

August 8, 2018 | <1 min read

“A CLOSLER Look:” Interview With Dr. Greenough

By Gretchen Miller, Managing Editor

"Every note I write, I include something about the patient as a person. Everyone needs to understand who the person is who is experiencing the disease." Watch and listen as Dr. Greenough shares a couple pearls of wisdom from over six decades of clinical experience in a five minute YouTube interview.

A drive-in BINGO game during the pandemic,

November 9, 2020 | 2 min read

Supporting Older Patients’ Emotional Health During The Pandemic

By Art Walaszek, MD, University of Wisconsin

We can support our patients’ well-being by encouraging safe social interactions and addressing psychiatric illness.

"Dreamscape." Painting by the author.

September 30, 2024 | <1 min read

Approaching the horizon 

By Jessica Berry, PhD, clinical psychologist

My painting, “Dreamscape,” represents the importance of acknowledging and addressing patients' feelings about aging and mortality.  

"A day in the life of a caregiver." Digital art by Lingsheng Li.

July 31, 2024 | <1 min read

A day in the life of a caregiver  

By Lingsheng Li, MD, MHS, University of California, San Franscisco

Family and friends caring for people with chronic illness often shoulder immense burdens without adequate support. Clinicians can help by expressing gratitude and/or acknowledging some of the challenges they face. 

June 13, 2024 | 2 min read

Lightening the load 

By Susan Lehmann, MD, Johns Hopkins Medicine

Clinicians can prioritize patient well-being by discussing the burden of engaging in care. Collaborate with patients to ensure recommendations are feasible and consider alternative approaches if necessary. 

June 10, 2024 | 2 min read

Let’s talk about sex and aging 

By Mariah Robertson, MD, Johns Hopkins Medicine

Open and inclusive questions during routine visits with older patients can improve their sexual health outcomes. 

"Caregiving is a bit of a mix of leaping and stepping—but in both cases, you never really know what's up next."

April 30, 2024 | 2 min read

Taking the leap

By Jennifer Woodard, MD, Medical College of Wisconsin

Caring for those with dementia extends to their caregivers. Often, that means simply being there to offer support.

February 22, 2024 | 1 min read

A journey through time 

By Beatriz Rizkallah Alves, MD, Massachusetts General Hospital

As a young doctor, I cared for a centenarian. I realized that I’d never fully appreciated the complexity and challenges of aging—I now take extra time to uncover my older patients’ struggles. 

November 30, 2023 | 1 min read

STD knows not your DOB

By Jeffrey Millstein, MD, Penn Medicine

Sex can be an important part of life in older age. My patient reminded me to address STD prevention and other intimacy concerns consistently in all sexually active adults. 

Black piece of paper with word Ageism concept.

November 16, 2023 | 3 min read

How to be anti-ageist

By Timothy Farrell, MD, University of Utah Health

Ageism can impede clinicians from eliciting what matters most to older adults. Practical strategies to oppose such sentiment can be implemented across clinical, research, and policy realms. 

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