by local guest writer Brittany Klaassen van Oorschot, ARNP
People with Alzheimer’s Disease thrive in familiar environments. They do best in the comfort of their own home with daily routines and often become agitated in new or uncommon situations. Historically, our healthcare system has struggled to adapt to these needs. Caregivers often take an entire day to bathe, feed, dress, and drive loved ones to their primary care appointments. Between checking in early, the appointment itself, and getting blood drawn afterward, medical appointments are often exhausting, frustrating events for patients and caregivers alike. Telehealth, or appointments held virtually by video consultation, can reduce the appointment burden by allowing patients to connect with their providers from the comfort of their own homes.
Benefits of Telehealth
Virtual appointments can save time, eliminate stress, and improve access to care. For patients living in rural settings or for family members driving first to a loved one’s home and then to a doctor’s appointment, the amount of time spent driving can be substantial. By doing a virtual appointment, patients are able to log on from their couch or dining table without any commute time. Furthermore, many of the new platforms used for telehealth allow multiple family members to participate in an appointment from various locations. For example, a patient can be at home while a daughter or son joins the video conference from their workplace. The result is less time spent for appointments and less disorientation for the patient.
Depending on the severity of the disease, when a patient with Alzheimer’s comes to a clinic setting, they are often stressed, confused, and unable to orient themselves. As a primary care provider, I see many patients with Alzheimer’s struggle to regulate their emotions while at our clinic. Patients cry, walk out of exam rooms, and even yell at loved ones when they are confused and disoriented. Unfamiliar environments make it difficult for patients with Alzheimer’s to manage their behavior, but telehealth allows patients to remain in a comfortable home setting. It also allows clinicians the unique opportunity to assess a patient while they are at their best cognitively. This can prevent overmedication and ensure the patient and clinician arrive at the best possible treatment plan.
Aging in Place
People living in their own homes despite advanced age and possibly complex medical needs are commonly said to be aging in place. For patients with Alzheimer’s, aging in place is great as it allows for routine. Operating within their own familiar environment often allows them to feed, dress, and bathe themselves independently for longer. Aging in place has been proven to improve quality of life and often reduces the cost of healthcare, especially for patients with dementia. Telehealth is poised to help patients age in place by improving the ease of access to their medical providers. With frequent appointments, careful medication and disease management, and close coordination with family and caregivers, I have seen many patients with dementia or Alzheimer’s age in place successfully. While I do think every patient circumstance is unique, I have seen firsthand how telehealth can help keep patients in their own homes longer by reducing the burden of an in-person appointment.
Limitations of Telehealth
Although virtual appointments are excellent for those with established diagnoses, it is nearly impossible for providers to formally diagnose a patient with Alzheimer’s or any form of dementia via a virtual appointment. For initial symptoms of memory loss, patients are often given extensive memory testing, laboratory work, and complete neurological exams. These are not possible via telehealth. However, once a diagnosis is established, virtual appointments make managing the disease much easier.
Adopting Technology
Technology can also be intimidating, especially for those with memory or cognitive impairments. Unfortunately, many older adults are resistant to using technology, but most telehealth platforms are increasingly straightforward and only require a smartphone with a camera, with no need for fancy webcams or microphones. Providers will often help patients navigate the telehealth platform themselves, and in the unlikely event the video conference fails, a phone conversation makes for a great backup plan. Additionally, most telehealth platforms have IT support when more help is needed. The constraints of telehealth are easy to overcome with the appropriate tools, and in my professional opinion, the benefits outweigh the downsides for patients with Alzheimer’s disease.
Overall, patients with dementia do better when they can age in place. Telehealth helps connect patients, providers, family members, and caregivers in an efficient and effective way. This improves the management of Alzheimer’s disease and helps keep patients in their own homes. Many patients and family members in my own primary care practice had anxiety about virtual visits at first but now prefer to be seen via telehealth and request these appointments. In fact, I have to convince some of my patients to come see me in person now! I strongly encourage caregivers, family members, and patients with dementia to familiarize themselves with any telehealth platforms available through their medical providers. Managing dementia will continue to be a complex and dynamic process, but virtual appointments can help mitigate the disease burden placed not only on patients but also on families or caregivers.
About the Author
Brittany Klaassen van Oorschot is a primary care nurse practitioner in Washington State. She has 10 years of experience in the medical field, initially as an exercise physiologist, then a registered nurse, and most recently as a nurse practitioner. In her clinical practice, Brittany is passionate about empowering patients through education. She finds medical writing to be the perfect creative outlet to continue fulfilling this passion, and aims to educate an even larger audience with her articles. In her spare time, Brittany enjoys skiing, mountain biking, backpacking, playing soccer, or paddle boarding throughout the Pacific Northwest with her close family and friends.
If you are a caregiver or an individual living with Alzheimer’s, you don’t have to do this alone. The Alzheimer’s Association offers free support groups throughout the region. To learn more, visit alzwa.org/support.
You can also find support and resources by calling our 24/7 Helpline at 800.272.3900. Our helpline is available around the clock, 365 days a year. This free service is staffed by specialists and master’s-level clinicians and offers confidential support and information to people living with dementia, caregivers, families, and the public.