Abstract
Objectives
Many adults older than 65 spend time in a nursing home (NH) at the end of life where
specialist palliative care is limited. However, telehealth may improve access to palliative
care services. A review of the literature was conducted to synthesize the evidence
for telehealth palliative care in NHs to provide recommendations for practice, research,
and policy.
Design
Joanna Briggs Institute guidance for scoping reviews, and Preferred Reporting Items
for Systematic Reviews and Meta-Analyses extension for Scoping Reviews frameworks
were used to guide this literature review.
Settings and Participants
Reviewed articles focused on residents in NHs with telehealth palliative care interventionists
operating remotely. Participants included NH residents, care partner(s), and NH staff/clinicians.
Methods
We searched Medline (Ovid), Embase (Elsevier), Cochrane Library (WileyOnline), Scopus
(Elsevier), CINHAL (EBSCOhost), Trip PRO, and Dissertations & Theses Global (ProQuest)
in June 2021, with an update in January 2022. We included observational and qualitative
studies, clinical trials, quality improvement projects, and case and clinical reports
that self-identified as telehealth palliative care for NH residents.
Results
The review yielded 11 eligible articles published in the United States and internationally
from 2008 to 2020. Articles described live video as the preferred telehealth delivery
modality with goals of care and physical aspects of care being most commonly addressed.
Findings in the articles focused on 5 patient and family-centered outcomes: symptom
management, quality of life, advance care planning, health care use, and evaluation
of care. Consistent benefits of telehealth palliative care included increased documentation
of goals of care and decrease in acute care use. Disadvantages included technological
difficulties and increased NH financial burden.
Conclusions and Implications
Although limited in scope and quality, the current evidence for telehealth palliative
care interventions shows promise for improving quality and outcomes of serious illness
care in NHs. Future empirical studies should focus on intervention effectiveness,
implementation outcomes (eg, managing technology), stakeholders’ experience, and costs.
Keywords
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Article info
Publication history
Published online: February 06, 2023
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2023 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
