Journal
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
Volume 28, Issue 11, Pages 1175-1184Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2020.07.019
Keywords
Caregiver; COVID-19 pandemic; dementia; telehealth
Categories
Funding
- Innovation and Technology Fund for Better Living awarded by the Innovation and Technology Bureau of the Hong Kong Special Administrative Region Government [ITB/FBL/2004/19/P]
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Objectives: Social distancing under the COVID-19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face-to-face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video-conferencing platforms could bring additional benefits to care-recipient with NCD and their spousal caregivers at home. Participants: Sixty older adults NCD-and-caregiver dyads were recruited through an activity center. Design, Intervention: The impact of additional services delivered to both care-recipient and caregiver through video conference (n = 30) was compared with telehealth targeted at caregivers by telephone only (n = 30), over 4 weeks in a pretest-post-test design. Interviews and questionnaires were conducted at baseline and study's end. Measurements, Results: Supplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone-only group (eta(2)(p) = 0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL-AD, eta(2)(p) = 0.23). Varying degrees of improvements in physical and mental health (Short-Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self-efficacy (Revised Caregiving Self-Efficacy Scale) were observed among caregivers in the video-conferencing group, which were absent in the telephone-only group (eta(2)(p) = 0.23-0.51). Conclusion: Telemedicine by video conference was associated with improved resilience and wellbeing to both peo-ple with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehmedicine beyond the context of pandemic-related social distancing should be considered.
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