A Videophone Intervention with Hospice Caregivers: Clinical Outcomes

1. A Videophone Intervention with Hospice Caregivers: Clinical Outcomes Debra Parker Oliver, MSW, PhD George Demiris, PhD Brian Hensel, PhD

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

3. 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

4. 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

5. 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

6. 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

7. Findings N=12 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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