Telehealth for older people – beyond the Covid 19 environment

When we think of digital technology, we tend to think of younger people using their smartphones and other digital devices. But this picture doesn’t necessarily apply to telehealth. Older people have been taking up digital technology, especially during the recent lock-downs. Through this, they are able to use telehealth to improve their access to care and this may assist ageing in place, which is the preference of most older people, who prefer at-home support to moving to residential care.

Assisting ageing in place

Even if there are informal carers who can help with in-home care, these still need the advice and support of the healthcare community. Telehealth can also reduce the burden on family members who undertake care for their older members.

Many informal caregivers will have responsibilities of their own, from raising children to holding down a job. If they can consult with the doctor in question from the comfort of their own home, they won’t have to spend as much time and money shuttling the person they care for to and from the doctor’s office or for hospital visits. At-home healthcare providers can quickly gain valuable insight and knowledge from remote consultations, improving the quality of care for the dependent person, improving satisfaction and wellbeing for both parties and probably enhancing the quality of care.

Value of telehealth

With population ageing, the number of older people with functional and cognitive impairments, who require assistance from others, will increase. Consequently, planning for their care calls for higher-quality and more cost-effective care, as well as better integration of health care and social support services. To help achieve these goals, telehealth services are increasingly included as a component of community-based care for chronic conditions, mental health, and even palliative care. These have the potential to keep older people independent longer.

Self-reporting

One example relates to diabetes sufferers. They can use tablet devices to share information on their physical, emotional, and psychological health through regular sessions with their doctors. They can track their daily food intake on a smartphone; upload their health data, such as weight, blood pressure, and glucose levels, and transmit these data to health professionals. This gives a much more complete view of health status and allows earlier, proactive care. This type of tele-messaging can help people with chronic conditions to learn self-management skills that allow them to take control of their diagnosis and monitor their condition at home.

Activity monitoring

Activity monitoring includes passive technologies—cameras, sensors, or other devices embedded in a home, and even on clothing — which allow an older person to be monitored without requiring them or another person to operate them. Such devices can monitor mobility and risk factors such as smoke and water leaks. We already have medical alert devices worn to detect falls. Alerts can be sent to caregivers if anything unusual occurs.

Barriers and Drawbacks of telehealth

If an older person feels confident using a computer or smartphone, they’ll be more likely to try telemedicine than one who feels computer anxiety. They must believe that they’ll be capable of successfully using this new technology.

Social context also affects whether or not telehealth services will be used. Older people who are surrounded by friends and family members using communication will also be more likely to adopt the practice. They’ll also be much more likely to try it if their doctor recommends it.

Telehealth must also be seen as safe and reliable. Older people must believe that their health information will be kept private and secure. If online financial transactions are viewed with suspicion, for instance, the same may go for telehealth. Reassurance from trusted people is essential.

Even though telehealth is often more convenient, some older people may prefer a traditional visit to the doctor. And, providers may insist that a face-to-face visit is the best way to diagnose and treat illnesses. So, telehealth is often best used as a supplement to in-person healthcare, rather than a replacement.

 Many critics argue that telehealth may negatively impact continuity of care built up by long-term partnerships with doctors who are familiar with life-long health histories. Receiving care from an unfamiliar doctor through a video app may not be a long-term solution for managing all chronic health problems.

Because telehealth is such a new field, there’s also limited data on its effectiveness as compared to traditional medicine. And there is still a long way to go before home telehealth is widely available, despite its use in the pandemic lock-down. As technology progresses and more care is delivered via telephone, video and other telehealth methods, more research will be needed to identify the models of care that provide the highest quality with the best consumer access, taking into account diverse needs and also demonstrating telehealth’s usefulness and cost-effectiveness.

About Age Concern New Zealand 'on research'

At the heart of everything Age Concern does is a passion to see older people experience well-being, respect, dignity, and to be included and valued. We support, inform and advise older people on issues such as access to health care, transport, housing, financial entitlements, and social opportunities. We also work to combat real problems in our society, like elder abuse and neglect, chronic loneliness and social isolation. We provide specialist services with trained and qualified professionals able to give expert advice and assistance. Age Concern is a charity and relies on the support of volunteers and public donations to do much of the work we do. To help us help older people, please consider making a donation of your time or money. To see how, visit www.ageconcern.org.nz
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