The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic

TLDR

Social distancing during COVID‑19 limited community services for older adults with neurocognitive disorder and their caregivers, and while telehealth is a viable alternative, telephone calls alone may be insufficient. The study evaluated whether adding video‑conferencing to telehealth could provide additional benefits to NCD patients and their spousal caregivers at home. Sixty NCD–caregiver dyads were randomized to 4‑week video‑conferencing or telephone‑only telehealth, with baseline and post‑intervention interviews and questionnaires collected in a pretest–posttest design. Video‑conferencing prevented cognitive decline, reversed quality‑of‑life deterioration, and improved caregivers’ physical and mental health, burden perception, and self‑efficacy, outperforming telephone‑only care within 4 weeks.

Abstract

ObjectivesSocial distancing under the COVID-19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face-to-face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video-conferencing platforms could bring additional benefits to care-recipient with NCD and their spousal caregivers at home.ParticipantsSixty older adults NCD-and-caregiver dyads were recruited through an activity center.Design, InterventionThe impact of additional services delivered to both care-recipient and caregiver through video conference (n = 30) was compared with telehealth targeted at caregivers by telephone only (n = 30), over 4 weeks in a pretest–post-test design. Interviews and questionnaires were conducted at baseline and study's end.Measurements, ResultsSupplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone-only group (ηp2 = 0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL-AD, ηp2 = 0.23). Varying degrees of improvements in physical and mental health (Short-Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self-efficacy (Revised Caregiving Self-Efficacy Scale) were observed among caregivers in the video-conferencing group, which were absent in the telephone-only group (ηp2 = 0.23–0.51).ConclusionTelemedicine by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehmedicine beyond the context of pandemic-related social distancing should be considered.