TELEPSYCHOGERIATRICS: CHALLENGING THE FUTURE
Telepsychiatry –through videoconferencing - explores the use of communications technology in mental health service delivery and has been utilized mostly in rural underserved areas and in islands. The application of telepsychiatry to elderly care–telepsychogeriatrics- is of special interest due to the increasing of elderly population.
In Greece, elderly mental health care in rural and geographical areas distant from centers is missing. Elderly are frequently afflicted by more than one pathological condition and are more vulnerable for presenting dementia and depression, problems that are of chronic nature and requiring repeated monitoring. Unrecognized depression, behavioral aspects of dementia, multiple medical and psychiatric co morbidities, are challenging goals in elderly mental health care. Furthermore, elderly patients with dementia and depression facing the greatest difficulties to gain access to mental health services.
Telepsychiatry in Greece through video-conference is running from 2004 with the island of Andros founded initially by a European Community (EC) Research Project (ISLANDS) and further by an unrestricted grant (ASTRA ZENECA). In the context of major telepsychiatry project the 1st Department of Psychiatry (Prof. G.N.Papadimitriou), developed a telepsychogeriatric project in collaboration with the Health Center of Andros Island, the Communities of Keratea, Byron, and Heliopolis, founded by Stavros Niarchos Foundation (SNF).
The main problem for the application of telepsychogeriatrics, through video-conference, was the elderly population located in remote areas, far from telepsychogeriatric unit (TpsyGU). In order to overcome this problem, our team has partnered with Top Creations to develop a mobile telepsychogeriatric unit (MTpsyGU) with the use of iPad as communications technology able to transmit and receive image and data of psychometric testing.
Up until today, all the tests were done in paper, resulting in pile of papers with information that would be hard to find and retrieve. The resulting iPad application is a standalone tool that contains all the pre-existing tests that are useful for the doctor that will visit a remote patient. The application is used both by the doctor to fill in the patients responses and reactions or directly by the patient so that to draw or record something, if asked.
After having completed the tests at the patients residence and when the doctor will have access to a wi-fi network, can synchronize the data into a central system. Accredited personnel from within the hospital has access to an administrative web interface where one can see the results of the tests in a friendly and meaningful format.
Through this project mental health specialists are able to reach elderly people in remote areas. It seems that in the field of telepsychiatry, telepsychogeriatrics will be experiencing further growth in the near future, due to the greater needs of geriatric population and the evolving of both technology and mental health providers that are more technologically literate.
Antonios Politis MD
National and Kapodistrian University of Athens
1st Dep.of Psychiatry, Division of geriatric Psychiatry, Eginition Hospital