Lynn Shaughnessy, PsyD; Image credit: BIDMC

Telemedicine may support better access to psychiatric care in nursing facilities, easing the challenges of care for residents with psychosis, and possibly helping some facility operators to expand their care offerings, an expert panel contends.

Psychosis is a primary cause of nursing home placement for people with neurodegenerative diseases such as dementia and Parkinson’s disease. Telemedicine use has been shown to be successful in long-term care facilities, including in care for residents with neuropsychiatric symptoms, according to Lynn Shaughnessy, PsyD, of Harvard Medical School. 

She and her co-authors, psychiatrists and geriatricians, have created what they say is the first guidance for effectively using the technology to assess and manage psychosis in people with neurodegenerative disease in this setting. 

Their recommendations, published on Jan. 12 in JAMDA, are the result of a consensus panel conducted in during the pandemic. Detailed suggestions cover best practices for handling administrative and technical challenges, evaluation and diagnosis, and treatment and monitoring. The authors also explain the benefits and challenges of using the technology in long-term care facilities.

A team-based approach is critical to success, the authors say.

“[A]cceptance by administrators sets a positive tone regarding the use of telemedicine and, thereby, empowers staff in resident care to participate in and support telemedicine visits,” they wrote. 

In addition, technical support is necessary, they said: “Ideally, the facility will have real-time support or an information technology staff available to address connectivity or other technology issues that occur.”

During a time when many long-term care operators are considering closing up shop, properly managed telepsychiatry may offer the option of providing more behavioral or psychiatric specialty care, Shaughnessy said.

Fully 42% of long-term care residents have been diagnosed with dementia in the United States, the authors noted. In addition, although only up to 7% of U.S. nursing home residents have a diagnosis of  Parkinson’s disease, nearly 25% of people with this diagnosis live in a long-term care facility.