Telemental Health Collaboration Protocol: What is the best way for rural nurses to help the elderly population decrease depression?
Goal
The goal of Rural Telemental Health (RTH) is to increase the access to those in the rural regions of states by using teleconferencing, video-conferencing, emails, group video-conferencing and the telephone to help the geriatric patient improve depression. Telemental Health and/or Telemedicine will also improve communication and collaboration with a team of healthcare providers such as rural clinic nurses and primary care physicians while giving the rural geriatric population access to a much needed health service.
Background and Statement of the Problem
The U.S. Department of Health and Human Services (2013) Report revealed that the World Health Organization describes the inequities and disparities within a community as social determinants. These social determinants include age, sex, birth place, where one lives, works, plays, race, ethnicity, sexual orientation, disability, and has a healthcare system. McKibbin and Deacon (2011) revealed it is estimated that 20% of older adults suffer from a mental health disorder. Patients with a chronic illness such as coronary artery disease, congestive heart failure, hypertension, geriatric depression, chronic pain issues, cancer, and diabetes account for trillions of dollars spent on medical care in the United States. As the population ages the costs will expand, the shortage of physicians and nurses will continue to decrease and the scope of this problem will increase thus the need for new innovative ideas and plans to care for the geriatric population including those in the rural regions. One potential solution for geriatric depression ...
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The Centers for Disease Control and Prevention (CDC) reports that 25% of people suffer from a mental illness and that 50% of people will develop one during their life ("Surveillance Report," 2011). Mental illness is also associated with “chronic diseases such as cardiovascular disease, arthritis, asthma, and diabetes” (Pederson et al., 2013, p. 695). Rural communities have higher rates of chronic illnesses, mental health issues and fewer providers thus making this population vulnerable to health disparities. The purpose of this paper is to explore mental illness in the rural community, ways to improve accessibility to care, and improve outcomes through the role of a rural nurse educator.
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Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to assist with diagnosis and treatment. As our society ages and health care costs increase, government and private insurance payers are seeking technological interventions. Technological solutions may provide high quality healthcare services at a distance, utilize professional resources more effectively, and enable elderly and ill patients to remain in their own homes. Patients may experience decreased hospitalization and urgent care settings, and out of home care may not be required as the patient is monitored at home. However, no study has been able to prove telehealth benefits conclusively. This change in health care delivery presents new ethical concerns, and new relationship boundaries between health care professionals, patients, and family members. This paper will discuss telehealth benefits in specific patient populations, costs benefits of using telehealth, and concerns of using telehealth.
The purpose of telemedicine is to remove distance as a barrier to health care. While telehealth is an accepted resource to bridge the gap between local and global health care, integrating telehealth into existing health infrastructures presents a challenge for both governments and policy makers (HRSA, 2011). Today there are policy barriers that prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns.
Implementing telehealth. support medical practice in rural/remote regions: what are the conditions for success? Implement Sci. 2006 Aug 24;1:18. Epub 2006 Aug 24.
More specifically, the transitions associated with later life like retirement, medical problems, death of a loved ones, reduced social networks leads to depression in aging population (National Alliance on Mental Illness, 2009). It is seen that depression is one of the most common mental disorder among adults aged 65 and older (National Alliance on Mental Illness, 2009).Depression is associated with anxiety and suffering that can lead to physical, mental, and social impairments. The presence of depressive disorders often negatively impact the course and complicates the treatment of other chronic diseases too (National Alliance on Mental Illness, 2009).According to National Alliance of Mental Illness there are more than two million of the 40 million Americans age 65 and older who suffer from some form of depression (National Alliance of Mental Illness (NAMI), 2009).
...ions model, Parrinello (2012) described the process of implementing new guidelines to screen for metabolic syndrome in a suburban psychiatric day treatment hospital. Guided by Rogers' diffusion of innovations model, Schaumberg, Narayan, & Wright (2013), developed, implemented, and evaluated a new evidence based practice project, Advanced Practice Nurse (APN) Psychiatric Bridging Intervention. By successful implementation of APN, clients required only 30-minute for initial psychiatric evaluation appointments compared to the typical 60-minute appointment. Moreover, Peeters, de Veer, van der Hoek & Francke (2012) examined the applicability of four perceived attributes in Rogers' diffusion of innovations model, which may influence the adoption of home telecare by elderly or chronically ill people, relative advantage, compatibility, complexity and observability.
Today, the world’s population is aging at a very fast pace and the United States is no exception to this demographic change. According to the U.S Census Bureau, senior citizens will account for 21% of the American population in 2050 (Older Americans, 2012). Although living longer lives may not seem like a negative sign, living longer does not necessarily mean living healthier. Older adults of today are in need of long-term health care services more than any generation before them (Older Americans, 2012). Because of the growing need for senior care, millions of families are facing critical decisions on how to provide care for their parents.
All randomized controlled trials that included older adults diagnosed as suffering from depression (ICD or DSM criteria) were included. All types of psychotherapeutic treatments were included, categorized into cognitive behavioral therapies (CBT), psychodynamic therapy, interpersonal therapy and supportive therapies.
The elderly represents a large amount of the population in our society and continues to grow each day. As the population grows, it is important to meet the demands and resolve the challenges that we encounter in regards to the overall quality of health and well-being of the elderly. Mental health of the elderly is a major issue but majority of the time goes unnoticed and untreated by caregivers and loved ones. About 20 percent of adults 55 and older are suffering from some type of mental health disorder, and one in three elderly adults do not receive any type of treatment (The State of Mental Health, 2008). Those suffering from mental illness are hesitant to seek out help or any type of treatment because of the stigma, services and cost for care that then comes with mental health disorders. Mental health issues that affect elderly include dementia, delirium, and psychosis. Some of the most common conditions include anxiety, mood disorders such as depression and bipolar disorder and cognitive impairment such as Alzheimer’s disease. Mental health is essential to the
In emergency situations, the first step in developing a telepsychiatry service is to assess availability of resources to deal with psychiatric emergencies at the patient sites, including health services (outpatient, inpatient, police, other), and the parties’ expertise in handling such emergency psychiatric situation (Shore, Hilty, & Yellowlees, 2007).
Telenursing is defined as the delivery, management, and coordination of care and services provided via telecommunications technology within the domain of nursing (American Association of Ambulatory Care Nursing, 2004). The terms “telehealth nursing,” and “telenursing,” are used interchangeably. To illustrate telehealth nursing the terms “home telehealth nursing” and “telehomecare nursing” are expressions having the same meaning. Both of these terms describe using technology and advancements in health care in the home care setting, in order to deliver nursing care remotely by a qualified health care provider.
The likelihood of acute or chronic diseases, or mental is substantially increased due to lack of income or resources. More and more research suggests that overall, older adults
Equal access to health services is a social justice issue and strategies to address access issues in rural communities should be an essential component of a healthcare system that strives for equality and universality (Health Research Unit Faculty of Medicine, Memorial University, 2013). As nurses, they should advocate for rural population and have their voices heard. In the meantime, nurses should actively engage in policy making to influence policy makers so transportation issues in rural areas can be shed light on and solved sooner. Nurses also can advocate for the modern technologies utilization such as taking advantage of telehealth to decrease the travel required for local patients to access specialty care. The telehealth service is not only expected to reduce the need for people to travel for a day or more in order to spend less than an hour with a specialist, but it also can reduce the cost associated with traveling.