By John Schall, CEO, Caregiver Action Network
Sophie’s dad was diagnosed with pancreatic cancer right as the pandemic shut down started. There were a lot of doctor’s appointments and tests to keep track of, and Sophie really needed to be there for all of the appointments – there was no way that her 87-year-old dad could keep track of everything the doctors said. The in-person visits went well – the cancer center understood that she had to be there. But when the appointments became video appointments, things got really complicated, really fast. Sophie got her father a webcam and taught him how to use it. But the first video appointment was set up as a FaceTime call – so Sophie had to teach her dad how to FaceTime. Then, there were a series of registration questions in some app that wouldn’t allow the text to appear large enough for her dad to read it, so Sophie took care of that, too. The next doctor wouldn’t let her join the video appointment unless she was in the same room as her dad. After several telehealth visits, it got easier and the benefits of not exposing her dad to COVID, outweighed the tech challenges.
What is a video appointment? Is it the same as telehealth? Is this even a real doctor’s visit? Is it covered by insurance? What if my loved one doesn’t have a smart phone or a computer?
These are only a few of the many questions surrounding the use of telehealth during the pandemic. In addition to everything else they do to take care of their loved ones, family caregivers now have to be the Geek Squad tech experts for video visits.
Many clinicians have adapted to using video visits better than they thought they would, with some reporting that they are engaging caregivers and family members in new ways. And while we all may miss in-person visits, for some, telehealth is easier and safer than in-person visits and are highly effective at reducing the risk of infection.
As one doctor put it “I did not think I would like telehealth, but I love it. I have met family members, engaged family in treatment, and even gotten a tour of a patient’s new apartment. It’s really shifted the relationship to be less hierarchical and more inclusive of those with disabilities or other barriers to care.”
From a caregiver’s perspective, while virtual visits are great, there is still some room for improvement. Some of the video conferencing platforms or health system policies do not allow a caregiver to join a visit from a third location. Pre-COVID-19, caregivers who drove a loved one to the doctor’s office would have been in the room during the appointment, serving as another set of eyes and ears. Caregivers help report symptoms, express concerns and ask questions. Without their caregiver’s present, some patients may be left confused, or unable to manage their own care.
Family caregivers need to be able to engage in a virtual visit the same way they would if they were in the exam room with their loved one, and health insurance, including Medicare and Medicaid, needs to continue to pay for virtual visits and to allow family caregivers to connect to virtual visits from a third location if necessary.
The current, temporary waiver that allows Medicare to pay for telehealth for all enrollees should be made permanent. As policymakers consider extending and further expanding telemedicine capabilities, they should consider the role of caregivers. Caregivers are vital to ensuring adherence to their loved one’s care plan.
About John A. Schall, M.P.P. (Chief Executive Officer, Caregiver Action Network)
John Schall is a public policy and communications professional with more than 30 years of noted expertise in a wide range of policy fields, including healthcare, labor, education, economic development, taxation, and budget policy. He became Chief Executive Officer of the Caregiver Action Network (the National Family Caregivers Association) in June 2012. Prior to CAN, Mr. Schall handled government relations for several companies and organizations.
Caregiver Action Network (http://www.CaregiverAction.org) is the nation’s leading family caregiver organization working to improve the quality of life for more than 90 million Americans who care for loved ones with chronic conditions, disabilities, disease, or the frailties of old age. CAN serves a broad spectrum of family caregivers ranging from the parents of children with significant health needs, to the families and friends of wounded soldiers; from a young couple dealing with a diagnosis of MS, to adult children caring for parents with Alzheimer’s disease. CAN reaches caregivers on multiple platforms. CAN (the National Family Caregivers Association) is a 501(c)(3) non-profit organization providing education, peer support, and resources to family caregivers across the country free of charge.