COVID significantly accelerated the adoption of telehealth across patient populations: one Assistant Secretary for Planning and Evaluation (ASPE) survey by the HHS found the share of telehealth visits conducted through 2020 increased 63-fold in the wake of the pandemic.
Providers and Medicare patients across Massachusetts, Vermont, Rhode Island, New Hampshire, and Connecticut primarily drove this uptick, but the spike in telehealth proved statistically significant nationwide.
While widespread telehealth adoption was chiefly spurred on by the need for virtual patient visits during global lockdowns, the case for telehealth was further strengthened by the growing shortage of healthcare workers.
According to the World Health Organization (WHO), there is currently a global shortage of 4.3 million physicians, nurses, and healthcare staff — and experts predict this shortage will only worsen in the future. WHO estimates this shortage will reach 18 million by 2030.
Rural and remote health systems, hospitals, and physician practices are more likely to be negatively impacted by provider shortages. In this instance, telehealth creates the opportunity to increase access to care for patients in rural and remote health settings by giving these patients an easy, convenient way to connect with healthcare providers online.
As the geriatric population grows and the incidence of chronic disorders increases, the need for virtual care services will only heighten.
Fortunately, telehealth services can be an effective tool for managing chronic conditions in older populations. Particularly for older adults with depression, telehealth can significantly relieve depressive symptoms, which may lead to improved behavioral health outcomes.
One study found that there was no statistically significant difference in patient satisfaction and quality of life in elderly patients with depression being treated using telehealth services. Given these promising results, it’s vital that healthcare providers nationwide — and especially in rural or remote areas — embrace telehealth as a care modality for delivering necessary behavioral and mental health services to older adults suffering from depression.
Depression in Older Adults
Depression in older adults bears distinct symptomology, according to the National Institute on Aging.
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Irritability, restlessness, or difficulty sitting still
- Loss of interest in once pleasurable activities
- Decreased energy or fatigue
- Moving or talking more slowly
- Difficulty concentrating, remembering, or making decisions
- Eating more or less than usual, usually with unplanned weight gain or loss
- Thoughts of death or suicide
Despite the prevalence of mental health issues in geriatric populations, depression is often stigmatized in elderly communities. The CDC estimates about 20% of people aged 55 years or older suffer from some kind of mental health condition.
Unfortunately, they often suffer in silence. The most common conditions among geriatric populations include conditions like anxiety, cognitive impairment, and mood disorders, including depression.
Telehealth, when applied to mental health treatment, can have a positive impact on older patients with depressive symptoms.
In a recent report from MediTelecare, leveraging telehealth services to treat those with moderate to severe depressive symptoms was shown to reduce symptom severity in 84% of patients. Four-hundred and twenty-eight of 509 patients with moderate to severe depression symptoms experienced a reduction in severity on a repeat Patient Health Questionnaire-9 (PHQ-9) assessment.
The average reduction in PHQ-9 scores was 7 points, with 80% of patients having significant improvement, with a score of 9 or less indicating only minimal to mild symptoms. Research indicates that a combination of improvement in PHQ-9 scores of 5 or more points and scores at or below 9 points post-treatment may correspond with clinically significant improvement in depressive symptoms.
Therefore, these results may demonstrate the value of telehealth in treating geriatric populations suffering from depression.
And because telehealth is available to patients anywhere with an internet connection, these services can be a crucial tool in alleviating symptoms of depression in patients in rural or remote locations who ordinarily may not have access to care services.
Beyond Depression in Older Adults
Behavioral health services via telehealth can not only make an impact in reducing depression in older adults but can also positively impact the reduction of high-risk medications such as antipsychotics that can lead to negative outcomes such as falls and other adverse effects.
With the help of comprehensive mental health services via telehealth, using both psychotherapy and psychiatric medication management, patients can discontinue high-risk medications such as antipsychotics.
In our 2022 report, MediTelecare found 80% of skilled and long-term care facilities were able to reduce patient use of antipsychotics through the use of telehealth. Furthermore, 45% of facilities saw a reduction in patients that experienced falls while on an antipsychotic medication.
These encouraging statistics serve as a testament to the effectiveness of telehealth in reducing not only depression symptoms but also adverse health outcomes associated with antipsychotic use.
Conclusion
As telehealth use becomes more prevalent across geriatric patient populations, older adults can leverage mental health services no matter their location: whether they’re in a skilled nursing facility, an assisted living facility, or homebound in a remote or rural area.
The proliferation of this technology will assist in reducing severe depressive symptoms, antipsychotic use, falls, and the adverse outcomes associated with depression and other mental health conditions.
Ensuring older patients have access to telehealth and understand how to employ the modality to improve their quality of life is key to achieving improved patient health outcomes across a variety of mental and behavioral health conditions.
