A common misconception is that older adults have either no interest in the use of technology or cannot use technology platforms. But recent survey report says otherwise, 7 in 10 older adults know how to utilize a computer, smartphone, or tablet with internet access at home. Older adults want to adopt new technology but face a lot of challenges, this is also true for use of telehealth services. The same survey report also states that only 11 percent of elderly patients feel comfortable using telehealth. Telehealth allows patients to receive care remotely in a manner that is often more accessible and convenient than in-person care. In this article, we shared basic guidelines and tips which are useful, when you are providing telehealth services to elderly patients.
Things to Consider
Before providing telehealth services you need to understand the difference between elderly patients and others. Most elderly patients experience age-related changes in vision, hearing, touch, perception, mobility, and balance. Many of these declines begin at age 40. They may have difficulties with light perception, sensitivity to glare, reduced acuity, and impaired focus on nearby objects. Discriminating between background noises becomes more difficult as we age, and low-level sounds are muffled.
Most elderly patients experience some cognitive changes as a part of the normal aging process, such as slowed speed of processing, difficulty in multitasking, and small declines in episodic memory, which generally do not interfere with everyday functioning. There are some older adults whose cognitive impairments may be too advanced to use telehealth successfully (for instance, in severe dementia). However, some older adults with mild forms of dementia can use telehealth effectively with some modifications or adjustments. For instance, they may need a family member’s assistance to set up the telehealth account or to get the telehealth session started.
Providing Telehealth Services to Elderly Patients
Following are a few guidelines that can be considered before providing telehealth services to elderly patients:
- Don’t make any assumptions about elderly patients. Don’t assume they are uninterested in telehealth. Just like the rest of the patients, meet older adults where they are and talk about the pros and cons of telehealth. Provide a clear explanation of what to expect and let them know that most people experience while adjusting to telehealth.
- Contact the elderly patients over the telephone prior to the appointment to provide verbal instructions, test the telehealth platform, and ensure the older adult understands and is comfortable with the technology.
- Directly acknowledge that telehealth sessions can feel awkward. Reassure older adults that most people feel increasingly comfortable over time. Attempt to look directly at the camera as much as possible to mimic eye contact.
- While introducing telehealth service, use concise language, a larger font size, and include screenshots of each step of the process. Elderly patients will benefit from visual presentation modifications. For example, raise display/screen illumination, use matte surfaces instead of glossy surfaces. Auditory enhancements may also help the user experience i.e., adjust volume settings, offer closed captioning options with enhanced text size, suggest the use of headphone sets.
- When using a video platform, neutral visual background for you will ensure the elderly patients with visual challenges is better able to focus on you and no other stimuli in the background. Similarly, reducing noise on the provider’s end reduces auditory interference for the patient. Be aware of noises such as HVAC, white noise generators, and other sounds and seek to minimize these with the position of your equipment and the use of headphones.
- Ask your patient if they need movement accommodations for their sessions i.e., allow time for stretching, invite older adults to use items that may be of comfort like heating pads, comfortable chairs, etc.
- Provide an end-of-session summary of the goals, reading, and exercises to be completed between sessions. This can be advantageous for all clients but especially valuable for elderly patients.
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