Videoconference diagnosis and management of Choctaw Indian dementia patients

Abstract

Background To report a 5-year experience using videoconference (VC) technology to diagnose and treat adult members of the Choctaw Nation with symptoms or complaints of cognitive impairment. Methods Patients were given the option of VC or face-to-face clinic. Prior to their VC session, patients underwent neuropsychological testing, Clinical Dementia Rating, Geriatric Depression Scale and Neuropsychiatric Inventory, brain CT, and routine blood tests. Physical observations made by VC included eyesight, hearing, facial expression, gait and station, coordination, tremor, rapid alternating movements, psychomotor activity, and motor tests of executive function. Cogwheeling and rigidity were tested by our on-site nurse, who also obtains vital signs as indicated. Results From January 2005 to March 2010 there 47 clinics, 171 visits, and 85 unique patients. There were 52 new evaluations and 119 follow-up visits. The number of visits ranged from 1–8; length of follow-up ranged from 1 month to 4.5 years. The no-show rate for all VC sessions in 2009 was 3%, and only 2 subjects in 5 years refused further VC visits. Conclusion Once cultural barriers are dealt with, VC-based diagnosis and treatment of adults with cognitive disorders who live in remote areas is feasible and well accepted by patients and families.

International Perspectives on Nonpharmacological Best Practices for Dementia Family Caregivers: A Review

“…Clinicians were able to see the caregivers without having to do home visits, thus increasing the number of caregivers that could be helped in one day (Finkel et al, 2007). Similar results were reported by researchers at the University of Texas who used videoconferencing technology to provide services to patients and families in the Choctaw (Indian) Nation (Weiner, Rossetti, & Harrah, 2011). Another successful example is the computer-mediated automated interactive voice response (IVR) intervention by Mahoney (Mahoney, Tarlow, & Jones, 2003) that was designed to assist family caregivers to manage disruptive behaviors related to the patient's dementia.…”

A narrative review of the evidence regarding the use of telemedicine to deliver video‐interpreting during dementia assessments for older people

“…Powers et al, examined TM for assessing and diagnosis of dementia among rural veterans and found that the no‐show and cancelation rate was 5.4% lower for TM assessments compared with FTF assessments (Powers et al, ). In another study, Weiner et al () found that refusals and no‐show rates for TM assessments were 3% (Weiner et al, ). Three studies, examining acceptability using surveys found that participants would use TM assessments again (Parikh et al, ; Shores et al, ; Vestal et al, ; Wofford et al, ).…”

Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

“…Rural (Talihina) subjects were diagnosed on site by ADC personnel and/or by teleconference interviews augmented by more detailed on-site neuropsychological testing (which did not include the measures used in this study), CT or MRI scans, and appropriate blood tests (Weiner, Rossetti, & Harrah, 2011). …”