A Videophone Intervention with Hospice Caregivers: Clinical Outcomes

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A Videophone Intervention with Hospice
Caregivers Clinical Outcomes

• Debra Parker Oliver, MSW, PhD
• George Demiris, PhD
• Brian Hensel, PhD

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Acknowledgements

• This project was made possible through the
  funding of the John A Hartford Social Work
  Faculty Scholars Grant 2004-2006

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Background

• Family members and friends are essential
  caregivers for Hospice patients
• These persons often suffer adverse effects
• On the average they spend more than 6 hours a day
  assisting with care
• Those caring for a dying person have even higher
  demands
• 65 of hospice caregivers are over 75yrs

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Purpose

• Purpose of this study was to test the usefulness
  of videophones a a communication tool in hospice
  and gather data related to hospice caregiver
  anxiety and quality of life
• Hypothesis Videophones are a feasible tool for
  service delivery and allow development of an
  effective low cost intervention that can decrease
  caregiver anxiety and improve quality of life

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Methods

• Setting 2 Rural hospice agencies in Missouri
• Videophones installed- as a Supplement to
  traditional care- not a replacement
• Caregivers contacted every 2 weeks using
  videophone and asked instrument questions

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Instruments

• CQLI-R self report 4 question instrument using a
  1-10 scale
• S-Anxiety self report instrument measuring
  caregiver anxiety- 20 item with 1-4 rating
• Research Asst journal notes and observations

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Findings

• N12 in two sites over 18 months data collection
• 10 subjects had multiple measures
• 1 subject only had admission data
• 1 subject had 2 measures- withdrew after 4 weeks

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Findings

• Findings indicated that anxiety score decreased
  after use of the videophone despite the continued
  decline of the patient
• Quality of life scores did not change
  significantly

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Findings

• Most valuable data were journal notes of RA
• Caregivers willing to participate
• Caregivers flexible in problem solving technical
  issues
• Caregivers perceive technology as useful
  communication tool
• Caregivers reported technology provided ease of
  mind

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Findings

• Staff perceived that caregivers in the study
  called less frequently after hours.
• Caregivers had very positive perceptions of
  technology- and saw benefit from visual feedback
• Technology seen as user-friendly
• Only isolated cases of technical problems
• Staff reluctant to refer- Gate-keeping
• Different between programs

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Conclusions

• S-Anxiety and CQLI-R were useful tools with this
  type of study and population and indicate larger
  study could be beneficial
• Coping may be another item that is worthy of
  being measured
• Videophones are feasible tool and may be a
  delivery mechanism for further clinical
  interventions

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Plans

• Current NCI funded study to use technology to
  bring caregivers into hospice interdisciplinary
  team meetings
• Proposed study to deliver nursing and social work
  educational interventions for caregivers over the
  videophone

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References

• Demiris, G Parker Oliver, D Courtney, K Day,
  M. (In Press) Use of Telehospice Tools for Senior
  Caregivers A Pilot Study. Clinical Gerontologist
• Day, M., Demiris, G., Parker Oliver, D. (2007)
  Exploring Underutilization of Videophones in
  Hospice Settings. Telemedicine and E health,
  13(1)25-31.
• Demiris, G Parker Oliver, D Courtney, K.
  (2006). A study of the suitability of videophones
  for psychometric assessment. Behaviour and
  Information Technology, 25(3) 233-237.
• www.telehospice-project.org