Phone Consults Provide Guidance for Rural Caregivers of Veterans With Dementia

Phone-based consultations with specialists, or “e-consults,” helped rural caregivers of older veterans with dementia manage behavioral and psychological symptoms, according to study results published in Clinical Gerontologist.

“Findings support continued implementation of telephone and other virtual modalities of assessing and treating behavioral and psychological symptoms of dementia for older veterans, thereby increasing access to dementia specialists, especially for rural older adults and their caregivers,” wrote corresponding author Sowmya Iyer, MD, MPH, and coauthors from the VA Palo Alto Health Care System and Stanford University School of Medicine in California. 

Under the e-consult program, geriatricians reviewed patient charts and called caregivers to discuss behavior triggers, attempts at management, and medications. Both pharmacologic and nonpharmacological recommendations for handling behavioral and psychological symptoms were provided to caregivers during calls.

Among 364 veterans whose caregivers received the service, 97% of interventions included dementia education on disease progression and nonpharmacological strategies to help manage behavioral and psychological symptoms, according to the study. Some 94% of veterans received guidance on medication.

Travel miles saved under the program averaged 108 miles for each veteran, the study found.

“A limitation to e-consults,” researchers pointed out, “is the time needed to provide services compared to the maximum workload credit allowed.”

Reference:
Iyer S, Mehta P, Gould CE, Gara S, Brodrick MB, Tenover JL. Dementia ‘e’-consults for behavioral and psychological symptoms of dementia: improving access to specialty dementia care for rural veterans. Clin Gerontol. Published online February 11, 2023. doi:10.1080/07317115.2023.2177574