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 older adult population consists of people 65 and older (Miller, & Stoeckel, 2011). Depression is greater in women than men, however, the cause is unknown (Public Health Agency of Canada, 2010). Both, males and females who have been previously depressed or have a biological relative with depression, have an increased risk of depression (Public Health Agency of Canada, 2010). Seniors in long-term care facilities have a higher rate of being diagnosed with depression (14-42%) than those who continue to live within the community (1%-5%), therefore, levels of diagnosed depression fluctuate depending on location of residence (Public Health Agency of Canada, 2010). A recent Canadian study shows 44% of older adults living in residential care have been diagnosed with depression or have symptoms of depression (Public Health Agency of Canada, 2010). Depression can cause higher mortality rates, even when supplementary risk factors are considered, however, the reasons are not entirely understood (Public Health Agency of Canada, 2010). Studies have shown that older adults with depression are one and a half to two times more likely to pass on than those without depression (Public Health Agency of Canada, 2010).
Among the main aims of health care reform and improvement is expanding healthcare access to different populations, which have been subjects to underserving for a long period. These include the poor, the previously uncovered, rural societies, and the minorities, to mention just a few. Great challenges definitely lie ahead, since several individuals start seeking access to the primary healthcare clinicians (Arnaert & Delesie, 2001). Telenursing assures to be a crucial tool to meet such needs. It refers to making use of the telehealth technology in conducting nursing practice and delivering nursing care. Because of the quick telemedicine technology adoption within the healthcare institutions, telenursing emerges as a fresh tool that provokes discussions
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.
Acquiring a comprehensive understanding of the ailments encountered by the aging population is critical for properly providing the care that they require. Physical ailments, often easier to diagnose and treat are perceived to be the most prevalent hardships for aged people. However, studies show that a significant number of seniors are subject to mental illnesses. Thus, emphasizing the need for the important of mental health within the aging population. Though all mental illnesses have an unfavorable impact on the quality of one’s life, depressive and anxiety disorders tend to the most devastating for an elderly person.
Often the biggest barriers to accessing healthcare are cost and location. Lower income individuals just do not have the resources to have optimal healthcare, or cannot take the time away from employment to deal with health issues. One potential solution to help with these problems could be “telehealth.” Telehealth allows a lower level healthcare practitioner to communicate with a physician or specialists when necessary. Remote rural areas use a Physician Assistant or a Nurse Practitioner on location in remote areas. When procedures call for a physician, an internet or satellite link provides a teleconference with a physician who can prescribe appropriate treatment (Gangon, Duplantie, Fortin & Landry 2006). This could be implemented in lower income urban areas, allowing free clinics to lower costs, and require fewer physicians.
...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.
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
Imagine the ability to obtain healthcare services from almost anywhere in the world where you have access to a phone or computer. Now, imagine being able to provide nursing assessments, diagnosis, treatments, and recommendations to your patients from your home to almost anywhere in the world. Lauren Stokowski (2008) noted in her article that one fourth of the United States has rural residents. That number may appear small in comparison to the urban residences; however, rural residents have a tendency to to have “higher poverty rates, larger percentage of elderly, and tend to be in poorer health”. Could telenursing be a solution?