Recognizing the Many Benefits That Telemedicine Offers Assisted Living Residents

The use of telemedicine in senior care settings accelerated during the pandemic, and we’re still understanding the various benefits and ways that telemedicine can be used in senior care. From the findings of a new research study to the exciting ways that one senior care community is continuing to embrace telemedicine, it’s clear that this approach has lots to offer to the senior care industry.

New Study Identifies Telemedicine Benefits for Residents with Dementia

Brian Geyser, APRN-BC, MSN, vice president of health & wellness of at Maplewood Senior Living Center for Aging Innovation & Technology

A research study published in the May 2023 issue of the Journal of Post-Acute and Long-Term Care Medicine provides new insight into the benefits that telemedicine offers senior care residents with dementia. With telemedicine restrictions waived in March 2020, telemedicine helped patients stay connected with primary care providers during the pandemic, which was particularly important for residents with dementia who have high care needs. The study examined primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and dementias, focusing on racial and socioeconomic differences.

The study found that Black and Hispanic residents were less likely to use telemedicine early on in the pandemic, which may be a result of technological and financial barriers, lack of broadband internet, or preferences for in-person visits. The study found that those differences in telemedicine access didn’t last, and as the pandemic progressed, Black and Hispanic residents became more likely to use telemedicine to access primary care. In fact, telemedicine appears to have reduced racial and socioeconomic disparities in primary care access among older adults with Alzheimer’s.

The study’s results highlight the importance of better understanding the barriers to telemedicine care that exist between different communities. It also highlights the value that telemedicine can offer, including in a post-pandemic stage.

How a Senior Care Center Discovered New and Continuing Telemedicine Benefits for Residents

Brian Geyser, APRN-BC, MSN, vice president of health & wellness at Maplewood Senior Living Center for Aging Innovation & Technology, explains that telemedicine played a key role in providing care access to residents during the pandemic in his community. While Maplewood Senior Living had been doing some telehealth before the pandemic, and would occasionally help facilitate a telehealth visit for residents, there wasn’t a formal telehealth system in place.

“Once the pandemic hit, everything changed and telehealth became a necessity,” explains Geyser. “Our model is that providers of all stripes, including primary and psychiatry, come to our buildings to care for our residents in the setting. With all the restrictions from the pandemic and the fear around transmission and the requirements around PPE, it was really tough and providers weren’t mobile anymore. We had to quickly adapt to figure out how we could deliver healthcare in safe, practical, doable ways.”

The senior care community purchased tablets and iPads and equipped them with the apps needed to facilitate the telehealth visits. At the same time, recognizing that social isolation was going to be a major problem, Maplewood Senior Living partnered with Temi, whose robots have the ability to do virtual visits with families. “It was a lightbulb moment,” says Geyser. “We realized that we could use the Temis to do telehealth and virtual visits with family members.”

The robots also proved to be invaluable for residents who had COVID-19. While residents were in isolation, facilitating telehealth appointments was more complicated due to infection prevention protocols. “But robots could enter into the resident apartments, and we could control them at a distance,” Geyser explains. “They would wheel right in, pull up next to the resident, and the resident didn’t have to put PPE on. The doctor would come on the screen and could meet with the resident virtually without having to have a staff member in the space. The resident didn’t have to hold a tablet or touch any buttons.”

As pandemic restrictions gradually lifted, Maplewood Senior Living has resumed its traditional care appointments, but has also continued to have a higher volume of telehealth appointments than what was scheduled pre-pandemic.

The Temis have also evolved to fulfill a new need. “As technology advanced, a new generation of Temis can be fully outfitted with medical peripherals, like a stethoscope and blood pressure cuff,” says Geyser. “We wanted to see if we can leverage the new medical robots to do geriatric consultations on our residents.”

According to Geyser, the new robot application is about to roll out in Maplewood Senior Living’s Ohio location. “A Cleveland clinic geriatric doctor will be in her office, doing virtual geriatric consultations for our residents from many miles away,” he explains. “The physician can control the Temi and can drive it right down the hallway in our building. She can drive it to the apartment where our medical staff will be to open the door and let it in. It will roll into the apartment and start to perform a complete assessment.”

The Temi can see the resident’s environment, give the physician a full visual on the resident, and can do vitals facilitated by one of the nursing staff, who might help by putting medical equipment like the blood pressure cuff onto the resident. All of the data collected by the medical equipment is transmitted to the Temi, and then back to the Cleveland Clinic.

The Temi is also capable of performing a series of tests to check brain health and cognition. “It gathers that information and is able to produce a very comprehensive, focused assessment and recommendations, which are transmitted to the primary care doctor,” says Geyser. “It provides amazing access to world-class specialty physicians without them having to drive to the building. It’s a more efficient use of their time.”

Telemedicine continues to offer residents significant benefits. “The value is access and timely access,” Geyser says. “It’s much easier to get a provider to be able to do a telehealth visit on the fly or in an urgent situation than it would be to get them to come to the building or to transport the resident out. Our residents are older and frailer, and they have lots of medical complications. Often, it’s not good enough to just have a doctor who comes once a week.”

He notes that it’s increasingly difficult to transport residents with dementia as the disease advances. It can be disorienting and confusing to them, and it’s so much better to do a house call.” That house call allows a physician to see the residents in their natural environment, and how they’re responding to staff and programs. “We do telehealth on residents with dementia quite a bit for that reason,” Geyser explains.

Steps to Successful Telehealth

Geyser encourages senior care communities interested in further embracing telehealth to set up a system where the staff can facilitate the visit. “You can’t expect the resident to facilitate their own visits,” he says. “It often doesn’t go well. They might forget, they might not have their phone charged, and there are so many different technical issues that can go wrong. Train your staff to be able to do visits.”

He notes that preparation is key to a successful visit. “Make sure you have all of the information you want to impart onto the provider so they can take that information and target their assessment accordingly. It’s more optimized for the provider to be able to hone in on the problem with the right history.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.