15642, five numbers that have shaped my life. We all have a zip code that we call home, yet some of us can face detrimental health outcomes based on where we live. Dementia does not discriminate by zip code, but the comprehensiveness of care and patient outcomes often do. Rural families face greater barriers to accessing dementia care resources, which deepens inequities between urban and rural health care. Barriers include less access to specialists, fewer in-home or long-term care options, and longer travel times to name a few. Patients with dementia who live in rural areas have higher mortality rates, lower rates of physician visits, increased hospitalization rates, use in-home care services less compared to urban counterparts, and spend more time in nursing homes. Families in rural areas should not face worse outcomes simply because of where they live. Embracing technology, like a centralized resource app, can narrow the rural dementia care gap by streamlining care, promoting better health outcomes, and empowering both patients and caregivers.
The complexity of dementia care coordination
Dementia care is inherently multifaceted and complex requiring coordination between interdisciplinary teams to ensure comprehensive care. Yet, physicians often face significant time constraints in outpatient settings. Common barriers include restricted appointment times, differences in insurance approval, and difficulty staying up to date with resources that are continually changing. Consequently, physicians are limited in their ability to locate dementia care resources tailored to the patient’s needs. Services such as rehabilitation programs, in-home care services, or caregiver support can be challenging and time-consuming. A centralized resource app can streamline this process, enabling clinicians to efficiently connect patients with resources fitted to their specific needs. Embracing technology is a critical way to alleviate clinician stress while streamlining personalized care.
Bridging the geographic care gap
Research has shown that “nearly one in five Medicare beneficiaries who saw a neurologist traveled 50 or more miles one-way for care“. This staggering statistic highlights a significant barrier to care, especially for rural patients. Technology can bridge this care gap by connecting patients and their families to resources that support their needs, which can promote health outcomes and overcome how rural patients face higher mortality rates and longer hospitalizations. Statistics are clear about how dementia patients in rural areas are disproportionately affected by their zip code, emphasizing the need to utilize the benefits of technology to reduce inequities in access to care and empower patients and their families.
Supporting the hidden patients
The caregivers for patients with dementia are the hidden patients. Family members often serve as the primary caregiver for patients with dementia and can feel overwhelmed with how to locate services and coordinate care, leading to burnout and isolation. Caregivers face a burden that can seem unmanageable, emphasizing the need for physicians to address caregiver needs as well. Witnessing this care gap firsthand through family members who suffered from dementia inspired me to create a resource app that physicians can rely on to find services for caregivers, including support groups, respite care, and mental health information. Not only does technology address the difficulties caregivers face, it also can enable them to better manage care. Knowledge is power, especially in dementia care. The more equipped caregivers are to confidently navigate finding resources for things like cognitive rehabilitation, physical therapy, in-home care, and more, the better the quality of life for patients.
Technology as a bridge, not a replacement
The goal with promoting the use of technology in rural dementia care is not to replace in-person care, but to supplement it and bridge the distance until families can access what they need face-to-face with providers. Technology is not a perfect solution. Internet access remains limited in some rural areas, and not all families are comfortable navigating digital platforms, but these challenges are not insurmountable. Apps can be designed with offline features, clear and simple displays, and instruction guides for easy use. My app titled, “Resources for Individuals Living with Dementia and Their Families” includes sections for general dementia information, caregiver resources, in-home and long-term care, and therapy options. Physicians have reported that our app has been a useful tool to more effectively and efficiently provide patient-specific care, and we hope to assess the impact of our app from the caregiver perspective.
Through the support of policymakers, health systems, and medical providers, we can build digital solutions for rural patient populations and transform dementia care. Support from health care systems to design and utilize apps, such as the one I created, is necessary to bridge the rural dementia care gap. It is not just a smart policy but a matter of equity for the millions of patients and families navigating this disease.
Rachel Milke and Roshni Raj are medical students.
