Home-Based Video Telemedicine for Dementia Management

Abstract

ABSTRACTObjectives: Persons with dementia face barriers to attending in-person medical care. Despite the potential for video telemedicine to ameliorate these barriers, little is known about in-home video telemedicine for dementia.Methods: Outpatients of a dementia clinic were invited to participate in in-home video telemedicine, and reasons for enrolling or declining were tracked. Visit experience was directly compared between in-person and video visits.Results: Of 230 families invited to enroll in video telemedicine, 96% agreed to join or gave reasons for declining, with the primary reasons for participating being convenience and less disruption of routines. Lack of a computer was the main reason for declining. Those who agreed to participate and those who declined were demographically similar in terms of race and education, but slightly younger in the telemedicine group (patient mean age 79 v 84). Equivalent visit satisfaction was reported between in-person and video telemedicine.Conclusions: Persons with dementia and their families were willing to enroll in an in-home telemedicine clinic. Satisfaction with home visits was high and equal to in-clinic visits.Clinical implications: Video telemedicine is a promising dementia service delivery model for rural patients and others for whom travel to a specialty clinic is burdensome.Abbreviations: ADL: Activities of Daily Living; Home-CVT: Home Clinical Video Telehealth; iADL: Instrumental Activity of Daily Living; GRECC: The New England Geriatric Research Education and Clinical Center; IM: Instant Messaging; LTC: long term care; THT: Telehealth Technician; VA: Veterans Affairs; VAMC: Veterans Affairs Medical Center.