Dementia UK is the specialist dementia nurse charity. Our nurses, called Admiral Nurses, provide life-changing support for families affected by all forms of dementia. They help people with dementia stay independent for longer, and support the people caring for them. They have the time to listen and the knowledge to solve problems.
The Covid-19 pandemic has meant that many appointments with health or social care workers are now taking place remotely, either by phone, email or video call, rather than in person.
This leaflet has been written by dementia specialist Admiral Nurses and aims to help both the person with the diagnosis of dementia, and their family and friends, get the most out of remote consultations.
What is a remote consultation?
Since the Covid-19 outbreak, there has been an increase in the use of remote consultations, either by phone or by video call. Health and social care professionals who cannot travel to you or who have to change the way they usually work due to Covid-19 restrictions, can still offer you an appointment via a telephone or video consultation.
This means that people unable or not wanting to travel to hospital, a memory service, GP or other health and social care professional can still have appointments and assessments. There will still be times when people need a face-to-face consultation or appointment, for example, when a physical examination, assessment or procedure is necessary; or people are unable to communicate via the phone or video (even if they are supported by family or friends). In those circumstances, you will be advised of the Covid-19 control precautions you need to follow.
Telephone consultations (eg, hospital, GP or other health appointment)
You should get a text, email or letter in advance with a date and time for the appointment. Your doctor, health or social care professional will phone you for your consultation.
Telephone appointments can be more limiting than video, as the health or social care professional cannot see your or the person with dementia’s body language, to gauge what you may be feeling or trying to say.
There are some practical things you can do to get the best out of a telephone appointment:
Put the phone on speaker so that you can take notes easily
If they want to speak to the person with dementia, keep the phone on speaker so that you can all be on the call together
If you find it difficult to interrupt during a phone call, you could consider saying “excuse me”, and if that doesn’t work, tapping on the phone mouthpiece, to get them to pause
Video consultations are where you speak to a doctor, health or social care professional using the video camera on your smartphone, tablet device or computer.
There are a variety of ‘apps’ used for video consultations by health and social care workers. Please check with your GP surgery for additional advice on which they use.
To have a video consultation you need:
a smartphone, tablet device or computer that allows video calling – remember to make sure your microphone and camera are switched on and the volume is correct for you
an internet connection
a well-lit, comfortable, quiet and private space so that you and they can see and hear each other clearly
one of the standard video calling ‘apps’/software: Skype, Zoom or Teams. (You can also use messenger app WhatsApp to make video calls, and FaceTime if you have an Apple device – but these are less commonly used for meetings or appointments)
– To use Skype, you will need to download the software first and create an account
– To use Zoom or Teams, you do not need to download the app first if the person hosting the appointment invites you with a link. You can click on the link and choose to enter the meeting on your browser (ie, through the internet, without needing the software)
There are a few things you can do to get the best out of your video consultation:
Look out for an email or text with the link to your video appointment. If you have not received this the day before your appointment, contact the service
Check your equipment ahead of time: make sure the camera and the microphone work
If possible, sit in a well lit room, away from a window (sitting with a window behind you will cause you to appear in silhouette, so the health or social care professional cannot see your face)
If the person with dementia has not used video calling before, you could trial a call beforehand, to make sure you are familiar with the video calling method you are using, and to see how they respond to being on camera and to speaking with someone on screen. You could video call them yourself, or get a friend or family member to do so
If you find it difficult to interrupt during a video call, you could consider raising your hand, or using an ‘I want to speak’ card (please see Sources of support)
Your video consultation will be private and will not be recorded without your consent. You may also be able to invite others (such as a family member) to join your video consultation on their own smartphone, tablet device or computer, or in person with you. Do ask if you want someone else to be with you or if you might require an interpreter or British sign language support.
Tips for communication for all remote consultations
There are a few things you can do to make all remote consultations run more smoothly. These include:
Writing down anything that needs to be raised during the consultation in advance, including; changes in behaviour or symptoms, concerns or queries about medication, questions about tests that are due or you would like to request
Taking notes on what the health or social care professional says (please see Sources of support for the Dementia UK Guide to appointments, which contains space for your notes)
If you are supporting someone during their remote consultation, discuss what they want to get out of it and how much they want you to speak for them
Inform the health or social care professional if you hold lasting power of attorney (health and welfare) or have consent to speak on the persons’ behalf
Consider if it would be helpful to highlight to the health and social care professional any particular tips for communication that are most helpful for the person you care for, such as:
– explaining simply why the appointment is happening
– speaking in short, straightforward sentences
– avoiding open ended questions
Phone calls and video calls can be more challenging than speaking to someone face to face. You may feel tired after the consultation, so don’t be afraid to have some ‘time out’ afterwards.
What else might be helpful?
If a telephone or video consultation is not suitable for you, then discuss with the health and social care professional what/whether alternative arrangements can be made. Even during periods of infection control restrictions, health and social care teams should have a process for prioritising people who need to have a face-to-face consultation rather than a telephone or video call.
Finally, do feed back (if you want) to the health and social care team about what was beneficial or challenging about your remote consultation. As we all become more familiar with remote consultations, feedback helps improve or continue good practice.