by Audrey Kinsella, MA, MS
Can we get comfortable treating seniors in a hands-off way? New mobile PERS systems like the one we profiled last month, (Telehealth: It's Not Just For the Homebound Anymore) systems that allow infirm individuals to leave home but remain connected, may be hard to get used to. Longtime readers may recall a chiding I received from telehealth industry expert and first ATA president Jay Sanders, MD a couple of years ago (Keeping Seniors Independent: It All Makes Perfect Cents; An Interview With Dr. Jay Sanders).
Dr. Sanders observed that I needed to get in touch with today's seniors. He told me, "This is no longer the same elder population of 50 years ago," citing examples of engaged and connected persons between ages 55 and 75, working seamlessly with technologies. He stressed, "A new senior market is demanding attention from providers of all stripes to heed its desire to age in place in their own homes. Active, healthy seniors biking and canoeing populate telehealth marketing literature, not the homebound with multiple chronic conditions."
It is from conversations with visionaries such as Dr. Sanders that writers who cover home telehealth have begun to think differently about how telehealth and PERS vendors can meet the demand to provide services to seniors when and where needed. We only need to glance at those product brochures to see that thinking in traditional ways about today’s seniors really is out of touch.
New Ways to Deal with Today’s Seniors
Before abandoning tradition completely, however, we still have to manage health care at home Medicare beneficiaries patients, who for now are still required to be homebound in order to receive your services. Church, yes. Day-long bicycle trips, no. But just because their homebound status remains traditional, the care you provide via remote patient monitoring does not have to be.
I mentioned my new Information for Tomorrow web page last month. A featured article there describes an example of one of these new care protocols, offered by Advanced TeleHealth Solutions of Springfield, MO. (See Tools That Work) This case example indicates how nurses engage healthcare at home CHF patients with a team approach. Before scheduling 83 heart failure patients -- 41 assigned to telehealth, 42 receiving care without remote monitoring -- chronic care nurses were required to undertake motivational training courses. Motivational training was intended to better equip them to work with patients who were learning new ways of eating and managing routines.
As expected, both sets of patients did better than the norm, though the monitored patients did have slightly better outcomes. As a result of the motivational training, nurses kept their heart failure patients engaged in their new routines and patients learned to play a key role in their own -- what was to become -- lifetime, self-management routines. The patients were not "cured" of course, but they did learn to participate in and take responsibility for their own realistic goals, to be kept stable over the long term.
In the "Coming Home" section of the Information for Tomorrow site, Kevin Doughty, PhD, whose degree is in medical engineering, describes the tools and interventions he deploys to teach self-management to seniors newly discharged to home from hospitals. In the next segment of this HCTR series, we will detail Dr. Doughty’s work with technologies to keep home care patients, as he says, "...in touch and in control of their fears and vulnerabilities," a process he calls "reablement."
Audrey Kinsella, MA, MS, is HCTR's telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at email@example.com or 828-348-5308.
©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org