Journal of Gerontological Nursing

Enhancing Care for Older Individuals Through Telehealth

Bonnie Wakefield, PhD, RN

Abstract

Telehealth describes contact between a patient and a health provider via electronic communications. There is a wide range of electronic communication technologies that may be used in patient care including voice, video, and information processing technologies. Emerging technology that can be particularly beneficial in care of elderly individuals includes homebased data monitoring applications (e.g., vital signs monitoring), medication dispensing appliances, and technology-enabled nurse case management interventions. Telehealth may be most beneficial for elderly individuals, compared to other age groups, because it can address common issues such as difficulty with transportation, safety, isolation, memory impairment, and maintaining contact with geographically distant family members. Internet access provides further promise to connect elderly individuals to a wide range of social and healthrelated information sources from the convenience of their home.

The Journal has actively informed readers about use of technology in meeting the many health and social issues facing older individuals. Fulmer et al. (1999) compared daily videophone and regular telephone reminders aimed at increasing medication compliance in elderly individuals with heart failure. Not only were technologymediated reminders effective in increasing medication-taking behaviors, but quality of life scores improved as well. Wakefield et al. (2001) evaluated the feasibility of providing a nurse managed telehealth chronic wound clinic between specialists located at an acute care facility and individuals residing in a long-term care facility 90 miles away. The advantages of implementing the telehealth clinic included reduced travel costs and time for the consultant, and timelier follow-up for residents. Both nurses and residents were satisfied with telehealth consultations and felt it was a productive use of their time and skills (Johnson-Mekota et al., 2001). Another study evaluated community-based family caregiver training provided via teleconferencing (Rosswurm, Larrabee, & Zhang, 2002). The training improved caregiver resourcefulness, competence, and knowledge, and demonstrated that teleconferencing can bring needed education and group support to caregivers who are isolated or live in rural areas.

The Journal initiated a new section in January 2002 called Technology Innovations. This section focuses on how emerging communication and information technologies can be used to improve care and quality of life for elderly individuals. Potential topics of interest include descriptions of:

* Research on the efficacy, safety, and cost effectiveness of new communication and information technologies.

* Telehealth case management applications.

* Use of telehealth applications to implement evidence-based practice in remote facilities.

* The physical, psychological, cognitive, and social factors influencing successful use of telehealth for and by older individuals.

* Older individuals' perceptions of telehealth encounters.

* The effect of telehealth on reducing use of hospital and nursing home care.

* The role of computers and the Internet in enhancing care and quality of life for older individuals.

We encourage you to share your experiences with us in this new section.…

Telehealth describes contact between a patient and a health provider via electronic communications. There is a wide range of electronic communication technologies that may be used in patient care including voice, video, and information processing technologies. Emerging technology that can be particularly beneficial in care of elderly individuals includes homebased data monitoring applications (e.g., vital signs monitoring), medication dispensing appliances, and technology-enabled nurse case management interventions. Telehealth may be most beneficial for elderly individuals, compared to other age groups, because it can address common issues such as difficulty with transportation, safety, isolation, memory impairment, and maintaining contact with geographically distant family members. Internet access provides further promise to connect elderly individuals to a wide range of social and healthrelated information sources from the convenience of their home.

The Journal has actively informed readers about use of technology in meeting the many health and social issues facing older individuals. Fulmer et al. (1999) compared daily videophone and regular telephone reminders aimed at increasing medication compliance in elderly individuals with heart failure. Not only were technologymediated reminders effective in increasing medication-taking behaviors, but quality of life scores improved as well. Wakefield et al. (2001) evaluated the feasibility of providing a nurse managed telehealth chronic wound clinic between specialists located at an acute care facility and individuals residing in a long-term care facility 90 miles away. The advantages of implementing the telehealth clinic included reduced travel costs and time for the consultant, and timelier follow-up for residents. Both nurses and residents were satisfied with telehealth consultations and felt it was a productive use of their time and skills (Johnson-Mekota et al., 2001). Another study evaluated community-based family caregiver training provided via teleconferencing (Rosswurm, Larrabee, & Zhang, 2002). The training improved caregiver resourcefulness, competence, and knowledge, and demonstrated that teleconferencing can bring needed education and group support to caregivers who are isolated or live in rural areas.

The Journal initiated a new section in January 2002 called Technology Innovations. This section focuses on how emerging communication and information technologies can be used to improve care and quality of life for elderly individuals. Potential topics of interest include descriptions of:

* Research on the efficacy, safety, and cost effectiveness of new communication and information technologies.

* Telehealth case management applications.

* Use of telehealth applications to implement evidence-based practice in remote facilities.

* The physical, psychological, cognitive, and social factors influencing successful use of telehealth for and by older individuals.

* Older individuals' perceptions of telehealth encounters.

* The effect of telehealth on reducing use of hospital and nursing home care.

* The role of computers and the Internet in enhancing care and quality of life for older individuals.

We encourage you to share your experiences with us in this new section.

REFERENCES

  • Fulmer, T.T., Feldman, P.H., Kim, T.S., Carry, B., Beers, M., Molina, M., & Putnam, M. (1999). An intervention study to enhance medication compliance in community dwelling elderly individuals. Journal of Gerontological Nursing, 25(8), 6-14.
  • Johnson-Mekota, J., Maas, M., Buresh, K., Gardner, S., Frantz, R., Specht, J., Wakefield, B., & Flanagan, J. (2001). A nursing application of telecommunications: Measurement of satisfaction for patients and providers. Journal of Gerontological Nursing, 27(1), 28-33.
  • Rosswurm, M.A., Larrabee, J-H., & Zhang, J. (2002). Training family caregivers of dependent elderly adults through on-site and telecommunications programs. Journal of Gerontological Nursing, 28(7), 27-38.
  • Wakefield, B., Flanagan, J., & Specht, J. (2001). Telehealth: An opportunity for gerontological nursing. Journal of Gerontological Nursing, 27(1), 10-14.

10.3928/0098-9134-20030401-04

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