Using Telehealth to Treat Adults With Cognitive Impairment

A program incorporated at the Montefiore–Einstein Center for the Aging Brain (CAB) in Yonkers, New York, during the COVID-19 pandemic demonstrates that telehealth can be used to stay connected to older adults with cognitive impairment during public health emergencies, researchers reported.

Outcomes and lessons learned from the program were recently reported in Neurodegenerative Disease Management.

“Caregivers reported that the televisits adequately addressed all concerns that they had at the time of the visit,” the authors of the report wrote.

CAB, located in the New York City area, is a multidisciplinary center for the evaluation and management of older adults with cognitive complaints or neurodegenerative disorders. In the early stages of the pandemic, the specialty center developed a coordinated approach to reach its diverse population of patients and their caregivers, called Coordinated Care At Risk/Remote Elderly program (CCARRE).

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The program condensed the standard multistep process which new patients undergo to a telephone or video visit between the patient, caregiver, social worker, and neurologist. The visit included a review of the patient’s history and neuropsychiatric symptoms, a neurobehavioral exam and other assessments, and discussions on caregiver stress, advance care planning, emergency planning, and respite needs.

Following the visit, the neurologist prepared a treatment plan that was shared with the patient, caregiver, and the referring physician and primary care provider. Patients were referred to community-based organizations and clinical trials as appropriate.

From March 18, 2020, to May 18, 2020, 85 patients were evaluated as part of CCARRE. The visits led to 89 referrals to community-based service organizations and referrals to health services including telehealth counseling, physical therapy, and physiatry.

“Televisits and the use of video technology in healthcare will outlast the current public health emergency,” authors of the report wrote. “Telehealth has the potential to provide access to care/services to patients who otherwise would never receive it, especially those who live in resource-limited locations, those far from their nearest providers and those who are homebound.”

—Terri Airov

Reference

Weiss E, Malik R, Santos T. Telehealth for the cognitively impaired older adult and their caregivers: lessons from a coordinated approach. Neurodegenerative Disease Management. 2020 Nov 10;[Epub ahead of print].