Use of telemedicine-based care for the aging and elderly: promises and pitfalls

Abstract

Abstract:Telemedicine-based care provides remote health and social care to maintain people's autonomy and increase their quality of life. The rapidly aging population has come with a significant increase in the prevalence of chronic diseases and their effects, and thus the need for increased care and welfare. The elderly have become one of the main target groups for telecare technologies. Smart home systems allow older adults to live in the environment of their choice and protect them against institutionalization or placement in a nursing home. It gives the elderly person a feeling of reassurance and safety, and appears to be one of the most promising approaches to facilitate independent living in a community-dwelling situation. Telecare solutions give a new opportunity for diagnosis, treatment, education, and rehabilitation, and make it possible to monitor patients with a number of chronic diseases. It also reduces socioeconomic disparity with regard to access to care and gives equal chances to patients from urban and rural areas. However, although telecare has undisputed benefits, it also has some limitations. Older people are often resistant to use of new technology, in particular acquiring the knowledge and skills necessary for use of electronic devices and computer systems. Further, privacy and security are important elements when building confidence in telemedicine systems. Leaking of sensitive information, such as health or test results, may have a negative and far-reaching impact on the personal and professional life of the patient. Telemedicine-based care should now be personalized for the needs, capabilities, and preferences of the elderly, with adapta tion over time as care needs evolve. If technologies are introduced that are familiar, usable, desirable, and cost-effective, and able to be adapted to seniors' lives and plans, then telecare would become an integral part of the lives of the elderly in the near future, allowing them to function independently in a friendly home environment.

Not Yet Ready for Prime Time: Video Visits in a Home‐Based Primary Care Program

“…Personalization of OSA care entails placing OSA treatment decisions in the context of individual priorities and other health and social issues. 3 Asking older adults what matters most to them is a critical step to achieving personalized care, yet elicitation of health priorities in healthcare settings is uncommon. 4 Patient decision aids are one strategy for helping older adults make informed decisions.…”

“…2 Less work has been done to explore the use of telehealth video visits with homebound older adults and their caregivers. 3,4 Our home-based primary care (HBPC) program is situated within a large integrated health system in New York. We serve approximately 2000 patients with advanced illness annually using a high-touch, patient-centered team-based home visiting model.…”

Bakım Sürecinde İhmalin Yeni Bir Türü: Geronteknolojik Yoksunluk

“…Örneğin Jensen ve arkadaşları (2009) bakım alan, ailesi ve bakım verenlerle yaptıkları çalışmada geronteknolojinin olumlu katkı sunduğu 6 başlığı şöyle sınıflamıştır: (a) günlük yaşam, (b) sosyal iletişim, (c) emniyet ve güvenlik, (d) bakım faaliyetlerinde kalite ve yardım alma, (e) mutluluk ve etkinlik, (f) rahatlama (Jensen et al 2009, 225-226). Diğer çalışmalarda ise geronteknolojinin bakım verenler için hizmet sunumunda fiziksel zorlukların aşılması, bakım yüklerinin azaltılması, tükenmişlik sendromu ve stresin giderilmesi, yaşam kalitesinin artması, sağlığın korunması, iş memnuniyetini artırması, bakım verenin kendine zaman yaratması, bakım verilen kişiye daha fazla ve kaliteli zaman ayırabilmesi gibi olumlu yönlerine vurgu yapılmaktadır (Topo 2009;Neocleous 2013;Bujnowska-Fedak & Grata-Borkowska 2015). Buna karşın geronteknolojinin kimi olumsuz yanları da tartışılmaktadır.…”

“…Nitekim, geronteknolojiyi bilmeyen ya da hiç kullanmayan katılımcılar, geronteknolojik alet, cihaz, ekipman ve yazılımlardan örnekler gördükten sonra, bu ürünlerin yaşadıkları zorluklara ve sağlık sorunlarının birçoğuna çözüm olabileceğini belirtmişlerdir. Bu olumlu görüşler, literatürde yapılan diğer çalışmalarla da oldukça tutarlıdır (Topo 2009;Jensen et al 2009;Neocleous 2013;Bujnowska-Fedak & Grata-Borkowska 2015). Ancak, tüm bu olumlu kanaatlere rağmen, bakım verenlerin geronteknolojiyi kullanmamaları nasıl açıklanabilir?…”

Specific issues of the design for the elderly

“…Another example for avoiding a potentially risky situation is using a flood detector which can report an overflowing sink or bath in the event that the user leaves a tap running. Motion sensors distributed in the house can detect when there is no movement or movement is unusual (based on previous settings), and inform the user, caregiver or the security firm [11].…”