Effectively managing the symptoms of residents with dementia can require considerable clinical expertise. Unfortunately, many nursing homes lack access to the specialized expertise that could aid in their efforts. A recent study examined the use of videoconferencing to facilitate greater access for nursing home staff to specialized experts such as geriatricians, psychiatrists, and neurologists in order to aid their treatment of residents with dementia.
This study set out to explore a solution for a nationwide shortage of geriatricians as well as the considerable distance between many nursing homes and these medical specialists. Videoconferencing represents a time-efficient approach that can potentially overcome these hurdles. In the case of dementia, in the absence of expert input, caregivers in nursing homes may resort to antipsychotic drugs or even physical restraints to manage behavioral disorders.
The videoconferencing program took place in 11 nursing homes, and involved a biweekly videoconference for staffs to remotely discuss cases with the appropriate geriatric medical specialists. The impact of this videoconferencing over a period of 18 months was compared to a control group of 22 similar nursing homes that did not take part in the videoconferencing.
Although the use of physical restraints for behavioral problems associated with dementia has become less common, it does still occur in nursing home settings. The videoconferencing program proved particularly effective at reducing the use of physical restraints. Compared to the nursing homes that did not videoconference, there was a 75 percent lower likelihood of using restraints in nursing homes that could consult with experts remotely. In addition, the videoconferencing nursing homes were 17 percent less likely to use antipsychotics. While the videoconferencing nursing homes showed a decline in the number of residents restrained or taking antipsychotics, there was a slight rise in both in the control group. Residents of videoconferencing nursing homes were 23 percent less likely to have urinary tract infections as well.
This study suggests that videoconferencing with medical experts can be a successful technological approach for organizations providing care to older adults. The efficiency of videoconferencing can provide medical expertise that benefits the population being served, and which would otherwise be difficult to access.
Gordon SE, Dufour AB, Monti MLP, et al. Impact of a videoconference educational intervention on physical restraint and antipsychotic use in nursing homes: results from the ECHO-AGE pilot study. Journal of the American Medical Directors Association (2016); Vol. 17(6): 553-556.