Using telehealth to avoid hospital admissions and improve the quality of life for people with dementia in residential care homes

Abstract

Introduction: Among people living in care homes, hospital admissions for avoidable conditions are 30% higher for people with dementia. An estimated 30% of older people in hospital have dementia1 and they are often admitted as a result of avoidable conditions such as dehydration, UTIs and complications as a result of long-term conditions. Once in hospital, people with dementia stay longer and have poorer outcomes than those without dementia.2 One of the reasons people with dementia are more frequently admitted to hospital is that they are often unable to communicate that they feel unwell and therefore their condition may not be identified until it reaches a more advanced stage. Implementing a system of health monitoring for people with dementia living in care homes could help to address the challenges care teams face in gathering reliable information on a regular basis from people living with dementia. Aims: The London Borough of Croydon and NHS South West London have a dementia strategy in place, which aims to improve support for people with dementia and their carers. This includes evaluating innovative strategies for delivering better care to people living in residential homes, such as introducing telehealth. Croydon Council has been piloting the development and use of Tunstall's myclinic multi-user telehealth system. The project aimed to assess the benefits for both the care home resident and the commissioner from the continuous monitoring of the client's health and wellbeing in their normal environment. This should to lead to more informed and better-managed care rather than unplanned and emergency interventions such as hospital admissions. Methods: Twelve residents with later stage dementia are currently using the telehealth system, care home staff having agreed with their family members that it is in their best interest to do so. Each morning a member of the care staff using the myclinic tablet will record the residents' vital signs and complete their bespoke health questions. This information is then securely transmitted to a central triage monitoring centre. If a user's readings are outside of the preset limits set for them in their care plan, markers are raised on the triage system and appropriate action can be quickly taken, enabling early intervention. Results: The myclinic solution has proven to be an effective support system, helping to provide person-centred care and improving quality of life by detecting possible health issues at an early stage, helping to prevent unnecessary hospital admissions. Early concerns that residents with dementia may be stressed and resist having their vital signs taken have proven to be unfounded. It is thought because the myclinic is portable and taken to the resident, rather than the resident going to a separate area of the care home to use it, residents are relaxed and accepting of the system. Telehealth monitoring has also become another opportunity for social interaction between staff and residents and is valued by both parties. Staff report that using myclinic has helped them to better understand the residents' health needs and has empowered them to help manage their care more proactively. [ABSTRACT FROM AUTHOR]