Tele-Rehabilitation for People with Dementia during the COVID-19 Pandemic: A Case-Study from England

Abstract

Introduction: The Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is delivering an exercise programme for people with dementia. The Lincolnshire partnership National Health Service (NHS) foundation Trust successfully delivered PrAISED through a video-calling platform during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This qualitative case-study aimed to identify participants that video delivery worked for, to highlight its benefits and its challenges. Interviews were conducted between May and August 2020 with five participants with dementia and their caregivers (n = 10), as well as five therapists from the Lincolnshire partnership NHS foundation Trust. The interviews were analysed through thematic analysis. Results: Video delivery worked best when participants had a supporting caregiver and when therapists showed enthusiasm and had an established rapport with the client. Benefits included time efficiency of sessions, enhancing participants’ motivation, caregivers’ dementia awareness, and therapists’ creativity. Limitations included users’ poor IT skills and resources. Discussion: The COVID-19 pandemic required innovative ways of delivering rehabilitation. This study supports that people with dementia can use tele-rehabilitation, but success is reliant on having a caregiver and an enthusiastic and known therapist.

Care for dementia patients and caregivers amid COVID-19 pandemic

“…While most published studies were in the form of guidelines and recommendations, there were several of primary research studies that were conducted 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 . The majority focused on telemedicine; demonstrating it to be a plausible way to effectively monitor persons with dementia [ 37 , 38 , 42 , 48 ] and to conduct rehabilitation activities remotely [ 36 , 45 , 47 ].…”

“…Among the articles/studies included, there were 14 articles [ 6 , 11 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], 14 primary research studies 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 4 perspective articles [ 4 , 49 , 50 , 51 ], 2 commentaries [ 52 , 53 ], 2 guidelines/recommendations [ 54 , 55 ] and 1 brief report [56] . These articles/studies were from (based on first author/location of research study) Canada [ 6 , 32 , 34 , 51 , 56 ], Italy [ 23 , 28 , 37 , 43 , 47 , 49 ], United States [ 26 , 27 , 29 , 33 , 35 , 39 , 41 , 42 , 52 ], United Kingdom [ 12 , 24 , 30 , 31 , 40 , 45 , 46 , 48 ], India [ 4 , ...…”

“… Care Setting Canada Article Technology enabled interactions with family members and health care staff [56] . Care Setting Canada Brief report 6 Physical exercise Daily exercises and walking indoors and in parks 51 , 52 , 53 Community Dwelling, Care Setting Singapore, Canada, United States Commentaries, perspective article Video-call based exercise programmes [45] . Community Dwelling United Kingdom Primary research 7 Overcoming social isolation Frequent phone calls and emails [ 39 , 51 ], TV and telehealth technologies, videoconferencing, tablet-based applications, game consoles, assistive-technologies using virtual reality to enhance social interaction among nursing home residents and family [ 27 , 28 , 49 , 56 ].…”

“…Amidst the COVID-19, both primary research studies and expert guidelines encouraged walking/daily exercises indoors or in the nearby parks 51 , 52 , 53 . Di Lorita et al, [45] implemented the promoting activity, independence and stability in early dementia (PrAISED) which is a home-based, face-to-face, individually tailored exercise program for PWD via remote interviews (telephone/video calls). PrAISED provided effective strategies to deliver rehabilitation remotely in situations with social distancing during the pandemic.…”

Construção de vídeos educativos sobre sofrimento psíquico e cuidado na pandemia do Covid-19: revisão integrativa

“…O potencial de custo e eficiência de tempo da tele-reabilitação foi observado. Viajar por longas distâncias (onde os serviços cobrem grandes áreas de captação) ou por um longo tempo (no caso de conurbações metropolitanas) para sessões de reabilitação face a face exige muitos recursos (Lorito et al, 2021).…”