Abstract
Family caregivers are vital to telehealth-delivered dementia care. The objective of this mixed methods descriptive study conducted in the VA Bedford Healthcare System was to examine caregiver satisfaction with a video telehealth dementia home safety occupational therapy evaluation. Ten caregivers of Veterans with dementia participated. Ratings of caregiver satisfaction, measured by nine Likert scale items including ability to see and hear, were examined in relation to person and visit-related contextual factors extracted from research assistants' field notes, to develop an in-depth understanding of caregiver experience. Person factors included caregiver age and gender and Veteran cognitive status. Visit-related contextual factors included occurrence of technical glitches. Caregiver visit satisfaction was overall positive, with exceptions related to technological glitches and the presence of the person with dementia during the visit. Veteran cognitive status appeared to influence caregiver satisfaction. Implications of the study are that proactively addressing technical glitches and incorporating dementia stage-specific approaches may optimize caregivers' telehealth experience.
Highlights
Caregivers are vital to telehealth-delivered dementia care
This study aims to address this gap by examining caregiver satisfaction of a video telehealth delivered home safety evaluation in relation to PEO factors
All but two caregivers lived with the Veteran
Summary
Caregivers are vital to telehealth-delivered dementia care. The objective of this mixed methods descriptive study conducted in the VA Bedford Healthcare System was to examine caregiver satisfaction with a video telehealth dementia home safety occupational therapy evaluation. Individuals with dementia experience progressive cognitive decline affecting judgment, communication, emotional, psychological, and motor functioning These changes lead to increased and evolving safety risks within the home environment, necessitating home modifications. Home safety evaluations for dementia are performed in the context of progressive cognitive deficits that affect individual functioning. As such, they are ideally client-centered, reflecting complex person-environment-occupation factors affecting individuals with dementia and their caregivers (Struckmeyer & Pickens, 2016). Behaviors such as wandering, and the degree to which caregivers are confident in promoting home safety, influence the relative success of home safety strategies (Horvath et al, 2005) All of these complex PEO factors are relevant to delivery of dementia home safety evaluations. Though occupational therapist-led home safety evaluations are the gold standard (CDC, 2019; Maggi et al, 2018; Pighills et al, 2016), in that occupational therapy (OT) practitioners are trained to consider the complex interaction of PEO factors, OT-led home safety evaluations are often not available (Lin et al, 2015)
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