7 best ways to manage a telehealth appointment
Although the COVID-19 pandemic has popularized telemedicine, some patients may find virtual doctor visits confounding.
They may not have the proper technology or understand it, and, because of COVID-19, might be isolated from family or caregivers who can help them, said Jami Carder, a registered nurse with the Visiting Nurse Association of Cape Cod, who, among other tasks, helps patients navigate telehealth appointments.
“This is a side effect of COVID….They’re on their own and they’re isolated and depressed and they’re missing appointments, and there’s nobody to follow up and make sure that they reschedule these,” she said. “They just kind of disappear and fall between the cracks.”
Even before the pandemic, many adults over 65 were flummoxed by telehealth, according to research at the University of California San Francisco, based on data from Medicare patients in the federally funded National Health and Aging Trends Study. More than a third of 4,525 respondents reported complicating factors such as inexperience with technology; difficulty with hearing or speaking; and possible dementia. The issues were particularly acute among those 85 and older.
Even caregivers might lack the knowledge or patience to download proprietary software or use phone cameras, Carder said. Some might not be in the same location as the patient and have to figure out how to join a conference call. It’s important that families take the time to understand what their loved one needs to get the medical care they require, or accept that telehealth might not work, Carder said. In some cases, agencies like the VNA can help.
“I have to teach the patient to manage their illnesses and their lives in today’s world,” Carder said. “And if they are unable to learn, then I involve our local resources like Elder Services of Cape Cod and the Islands, or I notify the doctor.”
There are things that older patients, caregivers and families can do to increase the odds that a virtual health visit will be successful, according to Carder and VNA occupational therapists Shannon Ryberg and Erin Fay-Azzato. For starters, practice. For example, Carder rehearses calls with patients, sometimes going into another room so they can test out apps like Facetime.
“I end up doing a lot of practicing with them, showing them the phone, teaching them,” she said. “And a lot of these patients really feel empowered after they actually learn something they thought was impossible before.”
Tips for a Smooth Teleheath Appointment
Here are six other things these VNA experts say patients, caregivers and families can do to help telehealth visits run smoothly:
- Download any required software or apps in advance and make sure your phone, tablet or computer is compatible. Set up the patient or helper with clear and simple step-by-step directions. Practice a video call, even if it’s with another app, so the patient understands the concept.
- Decide who’s going to be on the call and the best way to get them on it, whether that’s a conference call or setting a time that a caregiver and patient can be together in the same place.
- Designate a comfortable place to sit that works with the required technology. Don’t forget to mute the television!
- Update the patient’s blood pressure or other vital-sign logs and print them out or make them easily accessible.
- Have a list -- or the containers -- of all medications that the patient is actually taking. Sometimes in the anxiety of being discharged from the hospital, for example, patients may not realize that a doctor has changed prescriptions or updated doses. They may go back to taking the familiar medication or dose, Carder said.
- Brainstorm questions, concerns or comments about the patient’s daily life in advance and write them down. That way, you won’t be distracted and forget something important in the anxiety about technology. And, someone, either the patient or a helper, should take notes on what the doctor says.
- Get out ahead of telehealth. Even if a family member is still healthy or driving to doctors’ appointments, work on getting them technology at a level they can handle. It could help them manage their health in the future.
“You might not be there now,” Carder said, “but in the future you likely will be in a position where your parent is going to need care, and you don’t want to wait until they aren’t able to learn it.”