AI Article Synopsis
- Telehealth is being explored for rehabilitation among older adults, particularly veterans recently discharged from hospitals, focusing on enhancing mobility and physical activity.
- A study evaluated 45 older veterans, revealing many had disabilities and low mobility levels, with half experiencing mild cognitive impairment, affecting their ability to engage with telehealth services.
- While two-thirds used VA-provided tablets, many needed technical support or in-person assistance, indicating challenges in accessing telehealth, especially among those with cognitive and physical impairments.
Article Abstract
Background: Telehealth is increasingly used for rehabilitation and exercise but few studies include older adult participants with comorbidities and impairment, particularly cognitive. Using Veterans Administration Video Connect (VVC), the aim of the present study is to present the screening, recruitment, baseline assessment, and initial telehealth utilization of post-hospital discharge Veterans in a VVC home-telehealth based program to enhance mobility and physical activity.
Methods: Older adult Veterans (n = 45, mean age 73), recently discharged from the hospital with physical therapy goals, were VVC-assessed in self-report and performance-based measures, using test adaptations as necessary, by a clinical pharmacy specialist and social worker team.
Results: Basic and instrumental ADL disabilities were common as were low mobility (Short Portable Performance Battery) and physical activity levels (measured by actigraphy). Half had Montreal Cognitive Assessment (MoCA) scores in the mild cognitive impairment range (< 24). Over 2/3 of the participants used VA-supplied tablets. While half of the Veterans were fully successful in VVC, 1/3 of these and an additional group with at least one failed connection requested in-person visits for assistance. One-quarter had no VVC success and sought help for tablet troubleshooting, and half of these eventually "gave up" trying to connect; difficulty with using the computer and physical impairment (particularly dexterity) were described prominently in this group. On the other hand, Veterans with at least mild cognitive impairment (based on MoCA scores) were present in all connectivity groups and most of these used caregiver support to facilitate VVC.
Conclusions: Disabled older post-hospital discharged Veterans with physical therapy goals can be VVC-assessed and enrolled into a mobility/physical activity intervention. A substantial proportion required technical support, including in-person support for many. Yet, VVC seems feasible in those with mild cognitive impairment, assuming the presence of an able caregiver. Modifications of assessment tools were needed for the VVC interface, and while appearing feasible, will require further study.
Trial Registration: ClinicalTrials.gov NCT04045054 05/08/2019.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8456191 | PMC |
| http://dx.doi.org/10.1186/s12877-021-02454-w | DOI Listing |
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