Australian Residential Aged Care Facilities Managers’ and Nurses’ Experiences In Implementing Telehealth and Social Connection During COVID-19

Introduction: Residential aged care facility (RACF) residents are highly vulnerable to severe infection and death from COVID-19. During the pandemic, telehealth (telephone and video) provided a mechanism to deliver for health care and social support. We examined logistical factors associated with telehealth, reasons for its use and barriers associated with the choice of telehealth. Methods: A mixed method exploratory study. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using a hybrid framework approach; deductive analysis followed by inductive analysis for sub-themes. Results: Participants (n=19) reported an increase in telehealth use during COVID-19. Organisations bought new equipment, predominately tablets; half had internet connectivity difficulties; nurses used personal devices to overcome connectivity issues or inadequate devices and 74% used three or more platforms/software. Few residents had personal digital devices or could connect with family and friends alone. Five key sub-themes emerged from qualitative data. 1. Needing and persisting with telehealth. RACFs had limited video telehealth use before COVID-19. 2. Being dependent on health providers offering telehealth services. Telehealth was used for a broad range of services. However, many health providers did not offer telehealth consultations. 3 Residents living with dementia. Telehealth was suitable for residents with dementia, depending on the disease stage and clinical need. 4. Challenges with implementing telehealth consultations. Most challenges pertained to workflows. 5. Suitability of videoconferencing for social connection. Staff supported residents with video calls which were highly valued. Conclusion: To capitalise on and sustain telehealth activity in RACFs, further guidance and support to overcome operational barriers are required.