Tele-geriatrics and tele-nursing: Hospital at home for elderly with chronic diseases

Abstract

Introduction.– Dehydration is an important cause for acute physical and cognitive decline in frail elderly. Hypodermoclysis (HDC) used to bewidely unknown in our country until a decade ago. Thus, dehydrated NH residents were usually transferred to hospital for intravenous rehydration. Methods.– We offered lectures and training sessions to the nursing staff of 10 homes with a total of 1000 beds in our catchment area between 2005 and 2011. The chief nursing officers were interviewed before 2005 and after 2011, and questioned about their use of and experience with HDC and, if appropriate, reasons for their non-use of this technique. Results.–Before 2005, only 10%ofNHspractisedHDC,whereas after 2011, 90–100% of homes did so. Hospital admissions fell markedly although it was difficult to assess the true incidence. Unfamiliarity with the technique of HDC, doubts about it’s efficiacy and fear of off-label-use of i.v. infusions were the main reasons not to practise HDC. Conclusions.– By the means of information and training of nursing home staff, HDC could be established in most homes as a treatment of acutely unwell, dehydrated elderly NH residents without the need for hospital admission.