<scp>COVID</scp>‐19 and Telehealth in older adult psychiatry‐opportunities for now and the future

Sorinmade, Oluwatoyin; Kossoff, Lana; Peisah, Carmelle

doi:10.1002/gps.5383

Cited by 24 publications

(18 citation statements)

References 16 publications

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“…Avoid over-crowding in health facilities [46] Reduction in long distance travel [46] Minimize risk of serious events such as falls [46] Improve resilience and well-being [47,48] Able to perform an assessment in the living (ecological) environment [46,[49][50][51] Service patients from rural communities [52,53] Reduce secondary and tertiary infections [54] Reduce loss to follow up [55] W-Weaknesses Difficult to treat patients with cognitive impairment, visual acuity issues, and hearing problems [56,[60][61][62][63][64] Gauging patient comprehension by providers [65,66] Limitation in physical examination including gait assessment [66][67][68] Lack of older people's inclusion in the design and user-testing of telehealth interventions [56,61] Greater risk of treatment withdrawal and increased risk of hospitalization [69] Holistically manage dementia [52,56] Personalized management including reminders [53,57] Reduce caregiver involvement, including nursing home staff [52,58] Promote social connectedness among nursing home residents in particular [44,59] Management of video connectivity problems telehealth platforms [70] Maintenance of equipment, including its sanitization and the associated extra burden [55] Lack of privacy for the older person [71] Risk of missing out on clues of elder abuse due to the lack of pr...…”

Section: S-strengthsmentioning

confidence: 99%

“…Free communication platforms [44,59,[73][74][75][76] Readily available web-based training [77][78][79] Standardized documentation and real time reporting to improve quality of care [80] Digital photographs and asynchronous sharing to circumvent connectivity issues [77] Wearable devices, remote monitoring sensors and other technologies as early warning tools [59,81] Automatic speech analysis for diagnosis and monitoring of dementia [82] Enhanced integration of specialty expertise care of nursing home residents [70,83] Possibility of daily community collaborative rounds involving multiple services providers in nursing homes [84] Technology that is easy to understand pertaining to different interfaces, passwords, and maintenance [56,70] T-Threats Ambiguous/technical jargon for descriptive terms [85] Large variability of available telehealth platforms [70] Lack of sustained insurance reimbursement [11] Digital divide for some due to lack of equipment, limited literacy, and lack of assistance [56,63,72,[86][87][88][89][90][91][92][93] Ageism/stigma leading to de-prioritization of older people [94,95] Failure to include older people in standardizing telehealth [56] Lack of tested clinical tools for telehealth use [65,96] Technical failures and patient dropout …”

Section: O-opportunitiesmentioning

confidence: 99%

“…Thirteen articles (13/34; 38.2%) proposed older peoplefriendly policies and systems-strengthening approaches that would lead to improvements in the availability, accessibility, affordability, and quality of telehealth services. [61,73,85,91,94] Make an informed decision to use telehealth for health care services assessing the pros and cons [44,52,68,70] Discuss concerns with health care providers and explore solutions to mitigate concerns [70] Be part of blended communities that bring together online and in-person activities [91,99] Be involved in the process of standardization of telehealth use for geriatric care [70,85] Physicians and Other Health Care Providers Get trained in assessing patients using video conference [52] Convert current in-person screening and diagnostic tools into digital versions [52] Dedicate time in asking patients questions about concerns and barriers to accessing technology [93] Redirect patients to educational community resources for telehealth use when necessary [95] Technology Develop automatic speech analysis to diagnose and monitor dementia [82] Improve technology to accommodate age-related sensory and cognitive impairment [46,63,64,94] Replace ambiguous/technical jargon with easily understandable terms [64,100] Develop larger touchscreen tablets to make visual acuity less of a barrier [64,94] Use a simple and timely back-up process in the event of equipment or connectivity failure [70,97] Address hacking risk by ensuring the use of secure software [70] Governance/Health Systems Provide educational outreach to support older adults to use digital devices [87,91,94] Ensure sanitization of telemedi...…”

Section: O-opportunitiesmentioning

confidence: 99%

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Telehealth Use in Geriatrics Care during the COVID-19 Pandemic—A Scoping Review and Evidence Synthesis

Doraiswamy

Jithesh

Mamtani

et al. 2021

IJERPH

121

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Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization’s COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers.

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Section: S-strengthsmentioning

confidence: 99%

Section: O-opportunitiesmentioning

confidence: 99%

Section: O-opportunitiesmentioning

confidence: 99%

See 1 more Smart Citation

Telehealth Use in Geriatrics Care during the COVID-19 Pandemic—A Scoping Review and Evidence Synthesis

Doraiswamy

Jithesh

Mamtani

et al. 2021

IJERPH

121

View full text Add to dashboard Cite

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“…Recommendations regarding telemental health use Access to care Health service providers and policy makers must both recognize and advocate to reduce health disparities (35,103,126,154) Ensure adequate privacy and confidentiality protections (50,57,70,72,79,92,94,95,159,175,180) Prepare a device inventory (e.g., tablets) to share with marginalized populations (180) Standardize policies on licensing and regulatory issues (50,53,74,85,121,126,159,175,199) Financial impact Ensure patients are aware of billing and insurance policies up front (72,74) Ensure insurance providers expand coverage for telemental health (53) Malpractice insurance for telemental health services (175) Patient experience Prepare for the telemental health experience (53,85,121,126,133,167,180) Telemental health sessions should last for reasonable lengths of time, with a periodic break, if needed (176) Empower patients to participate and be an equal partner in their own care (176) Have one-on-one sessions prior to group sessions, schedule the group sessions at convenient times for all using differing modalities to maximize participation (57,91) Healthcare Develop tools to enhance ...…”

Section: Domainsmentioning

confidence: 99%

Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping

et al. 2021

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Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health).Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges.Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health.Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework.Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations.Systematic Review Registration:https://osf.io/4dxms/.

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“…Understanding the experiences of remote health care for people living with dementia is fundamental to shaping recommendations that will be relevant in times of restricted access to healthcare services, as well as the implementation of remote health care following the COVID-19 pandemic. 23 , 24 The aim of this study was to explore experiences of remote health care during the COVID-19 pandemic in the community, using a qualitative approach to provide insight on how implementation of remote consultations can take account of or compensate for disabilities or other needs related to skills and confidence, including access to technology.…”

Section: Introductionmentioning

confidence: 99%

Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers

et al. 2021

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Background: COVID-19 has accelerated remote healthcare provision in primary care, with changes potentially permanent. The implementation of remote provision of healthcare needs to hear from vulnerable populations, such as people living with dementia. Aim: To understand the remote healthcare experiences of patients living with dementia and their family carers during the COVID-19 pandemic. Design and setting: Qualitative interviews with community-based patients living with dementia and their carers during early months (May-August 2020) of the COVID-19 pandemic in England. Methods: Semi-structured interviews were conducted remotely by telephone or video call with 30 patients living with dementia and 31 carers. Data were analysed using thematic analysis. Results: Three main themes were derived relating to: 1) proactive care at the onset of COVID-19 restrictions, 2) avoidance of healthcare settings and services, and 3) difficulties with remote healthcare encounters. People living with dementia and their carers felt check-up calls were reassuring but limited in scope and content. Some avoided healthcare services, wishing to minimise COVID-19 risk, reduce NHS burden, or encountering technological barriers. Difficulties in remote consultations included lack of prompts to remember problems, dealing with new emerging problems, rescheduling/missed calls, and inclusion of the person with dementia’s voice. Conclusion: While remote consultations could be effective, pro-active calls could be more structured around needs, and consideration should be given to replace non-verbal prompts to describe problems, particularly for new health concerns. In continuing remote consultations, it is important to facilitate engagement with patients living with dementia and their carers to ensure best practice.

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COVID‐19 and Telehealth in older adult psychiatry‐opportunities for now and the future

Cited by 24 publications

References 16 publications

Telehealth Use in Geriatrics Care during the COVID-19 Pandemic—A Scoping Review and Evidence Synthesis

Telehealth Use in Geriatrics Care during the COVID-19 Pandemic—A Scoping Review and Evidence Synthesis

Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping

Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers

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