Due to the current COVID-19 pandemic, it is very difficult for people to visit their doctors. For some, this is not the biggest deal; they can stand to miss an annual check-up. For others, it is essential that they see their doctors. Thanks to technology, there are ways in which doctors and patients can communicate, with the main method being telemedicine. Unfortunately, this method is not available or easy to use for everybody. Older patients are especially struggling with this transition to telemedicine. Kimberly Wallace, a nurse practitioner from West Virginia who specializes in chronic kidney disease, highlights some of the difficulties for her older patients. 

About Chronic Kidney Disease

Chronic kidney disease (CKD) occurs when there is damage in the kidneys that progresses over time. About 26 million adults in the United States are affected by CKD. It is often the result of another condition, such as diabetes, high blood pressure, and polycystic kidney disease among others. Patients will experience the symptoms of their first disorder along with the effects of CKD, which include jaundice, stunted growth, high blood pressure, an enlarged liver or spleen, nausea, lack of appetite, vitamin deficiencies, fatigue, sleep issues, weakness, muscle cramps and twitches, changes in urination, persistent itching, shortness of breath, and swelling in the feet and ankles. Treatment is symptomatic and focuses on reducing complications and slowing progression. Doctors may prescribe diuretics, high blood pressure medication, cholesterol medication, anemia medication, and supplements to protect the bones. If CKD progresses enough, dialysis and kidney transplants may be necessary. 

Issues with Telemedicine

For older patients, technology is often confusing or inaccessible. Many do not have a device with a webcam or are uncomfortable using the internet. In places where a large portion of the population is above 65, such as West Virginia, the problem is even more prominent. 

While issues with telemedicine have always been present for the older community, the COVID-19 pandemic has complicated things even further. Some of Wallace’s patients have admitted to her that even though they had been using the internet to communicate with her before the pandemic, it was only with the assistance of their children or grandchildren. Now that everybody has to remain in their homes, they no longer have that help. 

These difficulties have forced medical professionals to move some of their appointments away from video calls, which were already not ideal, and towards phone calls. This makes it difficult to truly assess a patient. There are also components of care that need to be conducted in person. For Wallace’s patients, blood samples often have to be collected and analyzed to assess kidney function. This simply cannot be done over the phone or video call.

Positives of Telemedicine

While there are some glaring problems with telemedicine, there are also some positives. It can help define who needs an in-person visit, which lowers the amount of unnecessary travel to the doctor’s office or hospital. For patients who cannot drive or find it difficult to travel, this is a significant positive. Medical professionals can also have some insight into their patients’ everyday lives, which can be very helpful for treatment. 

Regardless of the negatives and positives, telemedicine is not going away. Technology has become a large part of healthcare, and that is not going to stop anytime soon. 

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