Virtual house calls: Helping people with dementia in rural communities

Dr. Roger Butler

Dr. Roger Butler’s “tele-gerontology” project could reduce the pressure on the long-term care system by delivering expertise in real time, reducing caregiver stress, hopefully keeping people in their homes longer and saving people unnecessary trips to the city for care.

The Alzheimer Society Research Program (ASRP) is investigating the potential benefits of connecting people with dementia or Alzheimer’s and their caregivers in rural areas to healthcare professionals in urban centres through video links.

The technology would bring instant treatment and advice into the homes of residents living hours away from healthcare services in a matter of clicks.

This is an advance that could address an urgent shortage of long-term care beds as the number of aging Canadians with Alzheimer’s disease and dementia rises, according to a release.

“It’s one of the major health crises our society will have to face over the next 30 years,” says Roger Butler, a Memorial University family medicine professor based in St. John’s, Newfoundland. “When government spends hundreds of millions on nursing homes as a solution without having all forms of assisted living and at-home programs in place, that’s a model doomed to failure.”

Thanks to funding supplied by the ASRP, Dr. Butler’s “tele-gerontology” project could reduce the pressure on the long-term care system by delivering expertise in real time, reducing caregiver stress, hopefully keeping people in their homes longer, and saving people unnecessary trips to the big city for specialized care.

Rachel Burton

Rachel Burton, a clinical psychology PhD student at the University of Saskatchewan’s Rural and Remote Memory Clinic, is doing a research study on the effectiveness of therapy delivered over video conferencing.

Dr. Butler’s team will provide tablet devices or home computers to 20 individuals living with Alzheimer’s. A nurse or doctor in St. John’s would check in weekly via video link, supporting the primary caregiver on anything from how to bathe the person in their care to getting him or her to bed.

“We want to see how we can keep people in their homes longer. People are happier in their homes; happier in their communities,” he says, adding caregivers feeling too overwhelmed are a major reason why people end up in long-term care.

“If you’ve got a well-educated, trained caregiver feeling supported in their community, they won’t burn out as quickly as if they’re left to their own devices,” adds Butler.

The effectiveness of therapy delivered over video conferencing is also central to Rachel Burton’s research on cognitive rehabilitation.

The 27-year-old clinical psychology PhD student at the University of Saskatchewan’s Rural and Remote Memory Clinic wants to help people whose cognitive skills are lost or altered when there is damage to their brain cells as a result of Alzheimer’s disease.

Video conferencing could help these individuals re-learn cognitive functions without having to leave their own homes.

“I’m still in Saskatoon, and people who are accessing the treatment would remain in their home communities,” says Burton. “I’m in a room and there’s a small TV screen, and they’re in another room with a screen, and we just talk.”

For example, for one Alzheimer’s participant who wanted to regain her ability to recall important personal milestones, Burton’s team compiled a photo album of the person’s significant life events which helped the individual re-learn names and relationships of family members.

For now, this work is being done in person. But in the next phase of the study, Burton will adapt the treatment to be delivered remotely through video conferencing. Rather than sitting together in the same room, participants will see and talk to each other using television screens. Burton anticipates that family caregivers will play a bigger role in video conferencing-facilitated treatment.

British trials have shown that cognitive rehabilitation can help people with dementia manage memory lapses, but requires weekly sessions with a trained professional. That’s not always available to rural residents, who have limited access to specialized health services.

Burton hopes her study will replicate the successes from the British in-person trials.

For more information visit alzheimer.ca.

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