Palliative Telemedicine Allows Patients the Dignity and Privacy of Remaining in Their Home

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A senior considers palliative telemedicine.

One of the final, and most important wishes most us share is going unfulfilled.

When we think of our final days, our last moments of life, we tend to hope they’ll be spent at home. It’s private and dignified, a familiar place where family and friends feel comfortable. It’s where we lived, and, unlike a hospital, it feels like a continuation of our daily routines, right up until they end.

Sadly, the majority of Americans won’t have that experience. Much less than half. That’s because end-of-life care is usually delivered in a hospital or hospice. As is becoming increasingly common in our digital age, however, there is technology available to help grant our wish to remain at home.

Palliative telemedicine, which uses video conferencing to link at-home patients with remote caregivers, is currently being trialed and could offer a solution. A simple webcam, tablet, or smartphone may be all we need to not only ease the pain of our final days but invite the friends and family we’ve accumulated throughout our lives to be with us.

Most of Us Want to Stay at Home

A survey by the California Health Care Foundation revealed that 70% of respondents wished to die at home. Only 32% of us will be granted that wish. Most of us (60%) will instead spend our final days in professional care.

It’s a legacy of the medical system that has served us for decades. Our medical experts and caregivers are grouped together in institutions such as hospitals to reduce costs and maximize their talents.

Telemedicine can disrupt that pattern, however. There are currently dozens of smartphone apps and platforms for both smartphone and desktop available to connect you directly with a doctor anywhere you are. Major hospitals and research centers are adopting remote medicine, including the Mayo Clinic. Even the U.S. Senate and state governments are passing legislation embracing telemedicine as a way to increase access to healthcare in remote areas.

And to our north, Canadian doctors are experimenting with palliative telemedicine to help us spend our final days at home.

Testing the Possibilities of Palliative Telemedicine

Research has shown Canadians also overwhelmingly prefer to receive end-of-life care at home. Sadly, they face the same disparity as we do between wish and reality. Researchers in the Champlain health region, surrounding the capital of Ottawa, are trying to redress that imbalance. They’ve launched a pilot project that will place video conferencing-enabled tablets in the hands of palliative care patients, so they can receive care at home. The trial will seek to improve the number of options people can pursue during end-of-life care.

Essentially, during the trial all the regular check-ups and consultations such patients would normally receive within institutional care are conducted over a video call. It is even possible to conduct physical examinations of a patient’s heart, lungs, ears, throat, skin, and temperature using advanced virtual medical devices. Add in the fact that many prescriptions can now be filled online and delivered to the home, and most of what makes up a medical checkup can be replicated over a video call.

The Canadians aren’t ready to make any concrete claims on the viability of palliative telemedicine, but if it proves to be at least comparable to on-site services, perhaps with the addition of regular visits from a nurse, it could give us all the ability to personalize our care.

Using Video Conferencing to Say Goodbye

Palliative care provides an extra layer of support alongside direct, disease-related medical treatments. While some doctors regard the practice as “giving up,” research has proved it is helpful in reducing anxiety and stress in both patients and caregivers, and is a way of honoring people’s end-of-life choices.

Providing that service within a person’s own home can only boost those advantages. Far from the rules, regulations, and sterility of a hospital, the home-based patient is free to entertain their friends and family as they have always done. And just as video conferencing allows the possibility of remote palliative care, it also offers the palliative care patient the ability see and interact with remote friends and family as well.

With an iPad by their bedside or a webcam hooked up to their laptop, people can receive their well-wishers no matter where life’s journey has placed them. It may even be more restful to have a series of one-on-one, face-to-face chats by video than deal with a bustling house of noisy guests.

Through the same screen they receive updates from their doctors, palliative care patients can speak intimately to all the people that shaped their life.

A final wish granted.

Image Source: Flickr CC User Adalie Plain

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