Palliative care among older adults presents many challenges, including the need to balance multiple medications and chronic conditions, to monitor nutrition and hydration closely and to provide emotional support as well as medical care. Some researchers think that palliative care is one of the rare instances where telemedicine may not be the right medicine.
A study published in the journal Telemedicine and e-Health examined the questions and concerns about the use of telemedicine in palliative care. Based on interviews with 17 healthcare professionals who were part of three different palliative care teams in Denmark between 2009 and 2010, the study found that although patients have a positive attitude about the use of telemedicine, the healthcare professionals had some concerns. And the biggest concern involved the ongoing telemonitoring of patients in their homes.
These caregivers expressed the importance of face-to-face communication with the patient over monitoring them with a camera or other device. It is through personal contact, they said, that the caregiver can become aware of subtle changes in patient appearance or behavior as well as establishing the necessary one-on-one personal relationship.
"We found that face-to-face communication is essential," the authors of the study said. "The participants perceived a potentially added communicative value in visual telecommunication but would never let it replace face-to-face communication. Our study underlines the necessity of face-to-face contact in optimal palliative care and that home visits were favored."