They have become an accepted, and in some cases, only method of seeing a doctor.
But new research that looked into dementia patients’ experiences of healthcare during the pandemic has warned that while video and telephone consultations may be convenient, they are not always for the best.
The research explored real life experiences of carers and dementia patients during the height of Covid and found patients learning of life-changing diagnosis by phone or online video calls could struggle to absorb the reality of the situation.
The University of Edinburgh research also highlighted difficulties faced by clinicians when it came to properly assessing a patient’s mobility and demeanour.
It also warned that in some cases ‘virtual’ consultations affected the way patients communicated with medical staff, and even sparked discomfort for health professionals who were unable to be sure of who might be listening in to conversations.
Although the research was limited to dementia patients, the findings raise questions over the rising use of remote consultations via telephone or online platforms for GP and hospital patients with a range of health issues.
A key finding of the report was that delivering difficult news concerning a patient’s health was best done face-to-face, with digital diagnosis seen as more difficult and impersonal.
Virtual care has become a common feature in GP surgeries and hospital settings as healthcare facilities strive to work through the impact of the Covid pandemic.
Recently, NHS Greater Glasgow Health Board advised patients with certain conditions such as sprains or strains to speak to a virtual A&E team rather than attend a casualty unit.
While research from The Health and Care Experience Survey showed less than two-fifths (37%) of patients saw their GP face-to-face last year, a fall of 49%.
Many dementia assessment and diagnostic services closed at the beginning of the first UK lockdown in March 2020.
As services began to reopen, many switched to remote consultations and online platforms for video calls and the telephone.
However, dementia diagnosis rates dropped by 7.6% in the UK during the Covid-19 pandemic, while recent figures showed Covid led to a five per cent fall in the number of deaths from Alzheimer's and other dementias.
According to public health figures, 6,046 people died from dementia in 2021, a drop of 306 on the previous year. Nearly two thirds of all deaths took place in care homes.
The Edinburgh University study found that while most people were understanding when appointments were delayed or held online due to the impact of the pandemic, it also led patients into a false sense of security, feeling their situation was not urgent.
When they eventually received an appointment and were given a dementia diagnosis, the news was received with even more shock and upset.
The report added: “Video call consultation could present challenges for some and it was felt face-to-face provided more opportunity for connection.
“It could be difficult for the person to understand what the healthcare professional was saying when not in the same room together and fully understand their meaning.
“Video call was suggested as a kind of “virtual reality” and “not the real world.”
It also found that the pandemic presented additional problems for people who received a dementia diagnosis during the pandemic, with some feeling the virus had robbed them of precious time.
Entitled ‘Understanding dementia diagnosis during the Covid-19 pandemic: patient and practitioner experiences’ the report made a series of findings to help healthcare providers plan for any future disruptions to patient care.
Significantly, it found that while making use of technology had benefits, patients needed to be given the choice over whether to be seen ‘virtually’ or face to face.
It also highlighted how kindness from healthcare staff or an apparent lack of compassion both have lingering impacts on patients and family as they progress through the illness.
The research was co-produced by “BUDDs”, which stands for Better Understanding Dementia Diagnosis. The group is made up of people with lived experience of dementia and researchers, including people directly affected when many dementia assessment and diagnostic services closed in March 2020.
Principal investigator Dr Tom Russ said: “Conducting memory clinic appointments by phone during the Covid lockdowns was very difficult.
“Clinics across the UK (and abroad) will be able to learn a great deal from our report.”
Louise Arnold, 43, from Edinburgh, whose mother, Muriel, was diagnosed with dementia just prior to the pandemic, took part in the research group.
She said the pandemic added to the stress of caring for her mother, but also brought unanticipated benefits.
“It was a hard two years, but I am almost grateful it happened because I was able to work at home and could keep watch on my mum.
“She would get up at 6am and wander the streets. We had to try to explain to her about talking to people and keeping a distance but she didn’t understand.”
A particular challenge was when her mother’s condition deteriorated and the family called for an ambulance. By midnight, and after waiting several hours with no sign of it, they put her mother to bed.
“At 5am, my dad was awakened with firemen trying to break down the front door,” she said. “The ambulance had arrived in the middle of the night, got no answer at the door - because they were sleeping - and, worried something had happened, called for help to get in.”
Muriel, a former bank computer programmer, died earlier this year, aged 79.
Louise added that one of the most touching moments was at the height of the pandemic when her mother, increasingly distressed by being taken to hospital, was gently spoken to by a young doctor.
“It was really stressful being in hospital, then a female doctor came in and spoke to my mum so well and put her at ease.
“She just knew how to negotiate with her without even knowing her and I was so grateful to her.”
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