Make the best senior care decision

Because telehealth is remote, it can be fitting for seniors who have limited mobility, limited access to transportation, or other factors that cause them to receive infrequent care.

“It’s always a challenge, especially for our frail, older patients, to come into the office,” says Cleveland Clinic Center for Geriatric Medicine Section Chief Dr. Ardeshir Hashmi. But the conveniences and increased access to care have “opened up a lot of avenues,” he says. “I think it’s the way of the future.”

Read on to learn Hashmi’s insights on how telehealth works, when it’s right for seniors, and how senior living communities utilize it to improve senior care.

Telehealth is the delivery of medical services through technology, often supplementing or replacing traditional, in-person health care. According to Hashmi, health care providers may offer a range of telehealth options, including:

• Virtual appointments. Also called e-visits, these allow your loved one to meet with a nurse or doctor through video when in-person visits aren’t necessary or feasible. Virtual appointments can be similar to in-person visits, Hashmi says. The nurse or doctor will ask your loved one questions about their medical history, assess their symptoms, and recommend treatment or follow-up visits as necessary.
• Online patient portals. Many offices offer patients access to a secure, private patient portal. When you log in to the portal, you or your loved one can access medical records, request medication refills, submit patient forms or questionnaires, and communicate with a physician or nurse.
• Health monitoring. Your loved one can use monitoring devices and their associated apps to track and record a number of health measures, such as blood sugar, blood pressure, sleep patterns, or heart rate. In some cases, these apps automatically send data to your loved one’s doctor to review.

Telehealth is convenient and offers opportunities to improve senior care, says Hashmi.

“I think health systems should be bringing that technology into people’s homes from the affordability angle, but also from the usability angle,” Hashmi says. Although seniors are often stereotyped as being challenged by new technologies, “many can actually can navigate the technology pretty easily,” Hashmi notes. “Our patients have done well with it.”

Things to consider before choosing telehealth

Depending on your loved one’s specific needs, there may be no substitute for in-person interaction with a medical professional. In-person visits are especially important during medical emergencies or if your family member has a health condition involving balance, the heart, or the lungs, Hashmi explains.

Some other factors to consider around telehealth use include:

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• Insurance coverage. Although a number of insurance providers, including Medicare, do cover e-visits and other virtual service costs, some providers don’t cover telehealth expenses. Coverage has expanded, but this was especially challenging in the early days of the pandemic, Hashmi says.
• Physical exams. Virtual appointments may end up requiring in-person follow-ups if your loved one’s doctor needs to conduct a physical exam. For physicians working through a virtual platform, “physical exams are the only limiting factor,” Hashmi says.
• Patient privacy. While patient portals offer convenience, Hashmi says that protecting patients’ online medical information is crucial, and notes that privacy leaks raise a potential challenge for telehealth. “Safeguarding against that is going to be another big challenge,” he says.
• Connectivity. For effective appointments, quality video and a solid internet connection are vital. With the proper equipment and know-how, telehealth services can be as intuitive as joining video calls with family and friends. Residents of rural areas may face the greatest challenges for successful e-visits, but with adequate technology, they may be the largest beneficiaries of telehealth’s advantages.

Telehealth is similar to senior care as a whole: It takes a team. With today’s technology, virtual collaboration allows for optimized delivery of a senior’s care. In senior living communities, telehealth allows staff members to give physicians real-time data on patients’ health metrics, Hashmi says, and also allows family caregivers to quickly coordinate with senior living staff.

And with telehealth’s ability to bridge geographical divides, Hashmi observes that more family members — even those out-of-state — can get involved in their senior loved one’s care with just a few clicks.

“One of the calls I’ve been on has been with family members simultaneously connecting from six different locations,” Hashmi says, noting how this increased family member involvement has been beneficial to seniors’ care coordination.

Hashmi sees location as another advantage for telehealth in senior living communities. Because appointments take place in a senior’s own living environment instead of a doctor’s office, physicians and family members can see more details relevant to a senior’s overall health, like prescriptions in a medicine cabinet, items in a pantry, and living arrangement specifics.

“With any care community, it has opened up a lot of communication,” says Hashmi.

A Place for Mom and Cleveland Clinic: Supporting seniors and their families

This article was developed in conversation with Ardeshir Hashmi, MD, section chief of the Cleveland Clinic’s Center for Geriatric Medicine, as part of a series of articles featuring expert advice from Cleveland Clinic geriatricians.

Sources:

Talk with a Senior Living Advisor

American Academy of Family Physicians. “How to collect patient vitals for telehealth visits, including AWVs.”

American Hospital Association. “Fact Sheet: Telehealth.”

Harvard Medical School. “Telehealth: The advantages and disadvantages.”

Leading Age. “The Future of Telehealth in Senior Living.”

Mayo Clinic. “Telehealth: Technology meets health care.”

National Center for Biotechnology Information. “Older Adults’ Perceptions of Home Telehealth Services.”

National Library of Medicine. “Effectiveness of telecare in elderly populations-a comparison of three settings.”

National Poll on Healthy Aging. “Telehealth Use Among Older Adults Before and During COVID-19.”

U.S. Centers for Medicare and Medicaid Services. “Telehealth.”

UpToDate. “Telemedicine for adults.”