Getting the most out of a remote consultation

Pros

• People who have difficulty travelling to appointments can access them from home
• It can reduce stress for people with dementia who feel unsettled in unfamiliar places
• People may feel more comfortable in their own home, giving the professional a clearer idea of their usual personality and behaviour
• In some cases, the increasing use of remote consultations has reduced waiting times for appointments
• Family members can join the consultation even if they live in different areas
• It is often possible to record the consultation and refer back to it later

Cons

• People who are unfamiliar with technology may find the process difficult or stressful
• There may be technical difficulties, for example an unreliable internet connection
• It can be harder for the professional to use the person’s body language to gauge how they are feeling or what they may be trying to say
• Physical symptoms like tremors and changes in gait are hard to see and assess remotely
• It can be harder to develop a rapport between the professional and the person with dementia
• Remote consultations can be hard for people with hearing difficulties
• Some memory assessment tools are unsuitable for remote use

When you book a telephone appointment, you should receive a text, email or letter giving you the date and time.

The doctor, health or social care professional will phone you for your consultation at the allocated time.

To get the best out of a telephone appointment:

• Make sure you are in a place with a good phone signal
• Put the phone on speaker so that you can take notes easily
• Have pen and paper handy so you can take notes
• If the professional wants 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
• If you are finding it hard to hear, ask the professional to speak louder, slower or more clearly
• Do not be afraid to ask the professional to repeat information

Video consultations can take place using a smartphone, tablet or computer.

They often use a well-known platform like Zoom, Skype or Microsoft Teams, but sometimes different apps, like Attend Anywhere (the NHS’s own video consultation app), are used.

You should be told which platform is used and provided with a link to join the consultation. If you haven’t received a link by text or email the day before your appointment, contact the health or social care service.

These tips will help you get the best from a video consultation:

• Choose a comfortable, well-lit, quiet and private space, with good WiFi or data signal
• Check your equipment in advance: make sure the camera and the microphone work
• If the person with dementia has not used video calling before, you could do a trial run with a family member or friend to familiarise them with the process
• 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 – see Sources of support, below
• If you are not using your phone for the appointment keep it close by – if there are problems with the video call, the professional may phone you
• As part of a memory assessment, the person may be asked to do some drawings. You can show these to the professional by holding them up to the camera
• Your video consultation will be private and will not be recorded without your consent. If you would like to record the consultation, inform the health or social care professional
• You may also be able to invite other people who are involved with the person with dementia – such as family members – to join the video consultation remotely, by sharing the link with them, or in person in the same room as you

• Ensure you have filled in any forms or other documents you have been sent
• Make notes in advance about what you would like to discuss, such as symptoms; changes in behaviour; medication; tests that you would like to arrange; test results
• Before the remote consultation, ask the person with dementia (if possible) what they want to get out of it and how much they want you to speak for them
• Before the appointment, or at the start, consider informing the professional of any communication tips that would help the person with dementia, such as explaining simply what the appointment is for; speaking in short, straightforward sentences; and avoiding open-ended questions like, “What do you think?”
• Inform the health or social care professional if you hold a health and welfare lasting power of attorney (LPA) that allows you to make decisions on the person’s behalf – see Sources of support for our information on LPA
• If you need an interpreter or British Sign Language support, request this in advance from the practice manager or secretary
• If the person with dementia wears glasses or a hearing aid, ensure they are wearing them
• Take notes on what is said
• Ask the professional to repeat or explain anything you do not hear or understand
• Make sure you are told what will happen next, eg when the person’s next appointment will be; whether tests are needed; where to pick up prescriptions etc
• Remote consultations can be tiring, so allow yourself and the person with dementia some time to rest afterwards
• If you would like to, contact the surgery or clinic after the appointment to tell them what went well and not so well – this will help them improve their remote consultations

If a telephone or video consultation is not suitable for you, then ask the person who arranges appointments if you can book a face-to-face appointment/home visit.

It may involve waiting a bit longer to see someone, but it should still be possible to arrange a consultation in person if needed.

If you would like to speak to a dementia specialist Admiral Nurse about making the most of remote consultations or any other aspect of dementia, please call our free Helpline on 0800 888 6678 (Monday-Friday 9am-9pm; Saturday and Sunday 9am-5pm) or email helpline@dementiauk.org.

If you would prefer to book a phone or video appointment with an Admiral Nurse.

Dementia UK resources:

• Practical guide to getting the best out of GP and other health appointments
• Next steps checklist
• Tips for better communication
• GP online services
• Lasting power of attorney (LPA)
• Caring from a distance

Other resources:

• NHS guide to video consultations
• NHS guide to what to ask your doctor
• Innovations in Dementia ‘I want to speak’ cards
• Remote memory assessments – a guide
• How to use Attend Anywhere