The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic

• Published in: The American journal of geriatric psychiatry Vol. 28; no. 11; p. 1175
• Main Authors: Lai, Frank Ho-Yin, Yan, Elaine Wai-Hung, Yu, Kathy Ka-Ying, Tsui, Wing-Sze, Chan, Daniel Ting-Hoi, Yee, Benjamin K
• Format: Journal Article
• Language: English
• Published: England 01.11.2020
• Subjects: Aged; Betacoronavirus; Caregivers - psychology; Coronavirus Infections - epidemiology; Coronavirus Infections - psychology; COVID-19; Dementia - epidemiology; Dementia - therapy; Dementia - virology; Female; Home Care Services - trends; Hong Kong - epidemiology; Humans; Independent Living - psychology; Male; Mental Health; Pandemics; Patient Care Management - methods; Patient Care Management - trends; Pneumonia, Viral - epidemiology; Pneumonia, Viral - psychology; Protective Factors; Quality of Life; SARS-CoV-2; Telemedicine - methods; Videoconferencing; Hong Kong; COVID-19 pandemic; dementia; telehealth; Caregiver
• ISSN: 1545-7214
• DOI: 10.1016/j.jagp.2020.07.019

Social distancing under the COVID-19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face-to-face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video-conferencing platforms could bring additional benefits to care-recipient with NCD and their spousal caregivers at home. Sixty older adults NCD-and-caregiver dyads were recruited through an activity center. The impact of additional services delivered to both care-recipient and caregiver through video conference (n = 30) was compared with telehealth targeted at caregivers by telephone only (n = 30), over 4 weeks in a pretest-post-test design. Interviews and questionnaires were conducted at baseline and study's end. Supplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone-only group (η  = 0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL-AD, η  = 0.23). Varying degrees of improvements in physical and mental health (Short-Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self-efficacy (Revised Caregiving Self-Efficacy Scale) were observed among caregivers in the video-conferencing group, which were absent in the telephone-only group (η  = 0.23-0.51). Telemedicine by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehmedicine beyond the context of pandemic-related social distancing should be considered.