LBDA

Telehealth: Easier Care for Those with Dementia with Lewy Bodies

by Carol Lippa M.D., Julie Maillie M.Ed. and Laura Brennan Ph.D.*
 
Managing doctor’s appointments can be a challenge for older people experiencing cognitive changes. People with Lewy body dementia (LBD) may experience additional symptoms affecting movement and behavior. This can make each part of the visit to a doctor’s office its own challenge, such as planning the trip to the clinic, finding parking, getting from the parking lot to the doctor’s office, spending time in the waiting room, etc.
 
To make it easier for LBD families, some healthcare professionals in specialty centers are using technology to provide healthcare services remotely. This virtual method of seeing patients is called telehealth or telemedicine.
 
The goal of telehealth is to improve access to healthcare, reduce patient stress, and the time and cost of travel. Over the last 15 years, telehealth research has shown itself to increase patient satisfaction as well. 
 
Telehealth appointments are just like normal healthcare appointments except the provider is not physically in the room. Patients and healthcare providers use video cameras like those on their computer, smartphones, or tablets for face-to-face health services. Patients and families download an app, and once registered, can log-in to make or attend their appointments. Specific questions or requests can also be submitted in advance and then addressed by the physician at the appointment time.
 
Telehealth can be done in several ways.  One way patients use telehealth is by vising a local clinic to meet virtually with expert doctors who are at a specialty center outside the patient’s locale. This saves the patient the burden of traveling the longer distance to the specialty center. Nurse practitioners in very rural areas can use telehealth to provide healthcare services that are supervised by specialists in another location.
 
Another option allows doctors to meet with patients in the comfort and convenience of the patient’s own home. This method is intended to relieve the stress, time, and cost of traveling to doctor appointments. It is most appropriate when the specialist is familiar with the patient, such as when minor medication adjustments are needed.  This type of telehealth service is ideal for reviewing routine test results, talking about responses to medication and/or dealing with behavioral issues.
 
Telehealth can cut the time and cost of traveling to major medical centers.  These expenses can be quite high, since many academic medical centers with experts in conditions like LBD are in major cities. Additionally, as caregivers often need to miss work for doctor’s appointments, telehealth may reduce the time they need to take off.
 
If people with LBD can use telehealth from their own home, they may feel less disoriented or confused. This may help them be more engaged and participate in the discussion with doctors and their caregivers. Also, telehealth allows doctors to observe changes in behavior that happens in a patient’s own home. This offers the doctor an opportunity to suggest practical tips to help manage these symptoms.
 
While telehealth offers exciting new opportunities, it does not fully replace in-person patient care. In-person doctor’s appointments are still needed for newly established patients or follow up appointments when more detailed physical and cognitive tests are necessary.  
 
This is a new healthcare model, and more research is needed to determine its strengths and weaknesses. The National Academic Center for Telehealth is an academic research initiative based at Thomas Jefferson University Hospital, which is focused on improving patient experiences through use of telehealth.
 
 
 
 
*About the Authors: Dr. Lippa, Ms. Maillie and Dr. Brennan are in the Department of Neurology at the Farber Institute for Neuroscience, Thomas Jefferson University Hospital in Philadelphia, PA.