Posted on Monday February 9 2015 by RIG Healthcare
We are no strangers to the well-rehearsed issues of the ageing population and the alarming statistics of cognitive impairment, which can lead to conditions such as Dementia and Alzheimer’s disease. Healthcare services are touched daily by the desperate need to increase diagnosis rates and ensure better care for people with cognitive disorders. General population trends are telling us that the adoption of mobile devices is ever increasing. As I have previously shared in my last blog; mobile working in healthcare, mobile technology is already disrupting the landscape of community healthcare. However, many older adults are yet to experience the benefits of such innovation.
The Community Rehabilitation Service I work with conducted a mobile working pilot. The ability to provide healthcare anywhere, irrespective of time and place is our ultimate definition of mobile working. For the pilot a range of electronic multidisciplinary forms were built that allowed the clinicians to carry out assessments using a tablet. The forms included a cognitive screening tool which covered the domains of attention and concentration, executive functions, memory, calculations and orientation. I wish to share my experience of introducing a mobile device into the practice of cognitive assessment for older adults.
George is 77 years old and was referred after surgery on his fractured hip. His rehab’ consisted of physical therapy to work on sitting tolerance and transfers. George was only able to manage 20 minute sessions due to pain and fatigue. He had mentioned he was becoming more forgetful and I noticed he was struggling to carry over techniques from one session to the next. George had little exposure to technology in his working life as a brick layer. I explained what the tablet was, how the stylus pen worked on the screen. George completed all the cognitive assessment tasks on the tablet. He sat on the edge of the bed for 45 minutes. He was engaged, motivated to do the assessment and did not complain of pain. The assessment helped me identify George’s cognitive strengths and weaknesses and to restructure the therapy to match his cognitive needs.
Charles is 79 years old and was referred from A&E due to having many falls. He disclosed that he was not managing his busy outpatient appointment schedule and he was worried that he was often forgetting where he left his wallet. This resulted in missing crucial medical appointments and having to cancel his bank card multiple times. By participating in the mobile cognitive assessment Charles was able to experience a rapid assessment of his cognition and receive results at the point of expressing his concerns. We were able to have a prompt discussion of the support options based on the assessment results. The digital assessment helped to increase the awareness of his cognitive needs to other healthcare professionals involved. Charles was also referred to the specialty memory service in a timely manner.
Betty is 83 years of age and is an active member of her community. After a hospital admission for pneumonia Betty reported forgetting new skills such as how to access her email. The mobile cognitive assessment identified impairment with concentration and short term memory. After a 6 week programme using a variety of cognitive stimulating apps on a tablet, improvements were observed in Betty’s functional performance. She was independent with turning on her tablet and accessing her emails to read, send and delete. Betty demonstrated increased concentration from 20 to 50 minute sessions. She experienced improvement in app scores that record working memory and an overall sense of enhanced cognitive confidence.
I hope that by sharing my mobile working experience I can help to dispel the myth that age is a barrier to the use of mobile technology in community healthcare. As frontline clinicians, we can play a big role in raising the awareness of the benefits of mobile technology and ensure our older clients are not digitally excluded. Sustaining independence as we age is highly dependent on good cognitive health. It is my prediction that mobile technologies will facilitate much needed rapid diagnosis of cognitive impairment and in turn contribute to better personalised healthcare.
By Melissa Andison, Interim Team Lead Community Rehabilitation/ Occupational Therapist / Mobile Working Champion LinkedIn Profile
This is part of our OT Series