Adapting person-centered care and communication during a pandemic, and beyond

UNIVERSITY PARK, Pa. — As COVID-19 pushes our communities to a state of continuous virtual environments, the need to adapt and improve person-centered care and communication for health care providers and their patients is crucial.

Penn State College of Nursing assistant professor and researcher Andrea Yevchak Sillner has been aiding in the development of these healthcare advancements, as her interdisciplinary research focus revolves around enhancing Person-Centered Care (PCC), communication, and symptom recognition among older adults, informal caregivers, and formal healthcare providers.

Erica Walton, a nurse educator at Penn State Health St. Joseph, demonstrates a heart technique on a high-tech mannequin, in a photo taken prior to the pandemic. Credit: ProvidedAll Rights Reserved.

These adaptations and improvements are made possible by technology-assisted communication (TAC) devices, such as everyday cellular phones, tablets or computers. Specifically, TAC devices have enabled community-dwelling older adults and their caregivers to communicate via email, texting, videoconferencing web-based portals or patient health portals, secure messaging systems, and telehealth visits — allowing for improved communication for routine appointments, check-ups, and comments and questions between healthcare providers and patients, said Sillner.

Sillner's latest research endeavor — determining the background factors such as intrapersonal, interpersonal and environmental factors that influence the use of technology-assisted communication in home and community-based settings of care from the perspectives of community-based, direct-care providers and administrators, older adults and their families — aims to better understand how older adults’ current use and preference of technology impacts these communications.

“Families and caregivers are using technology perhaps more than we even realize to communicate with healthcare providers,” Sillner said. “Whether that communication occurs formally through the use of electronic health portal or whether it's a more informal approach such as a secure text message.”

Caregiver and patients have been able to incorporate preferences for technology-assisted communication into the development and application of healthcare communication systems. Tailoring technology to preferences will enhance uptake of technology, potentially improving healthcare related communications, and ultimately positively impacting individual and family caregiver outcomes, according to Sillner.

Although technology has uncovered many advantages for people, it’s also important to acknowledge and resolve the disadvantages. Concerns for disparities to access remain, such as rural older adults having less access to internet service, lack of or low technical ability or general lack of technology acceptance, and the safety and security of sharing health-related information via technology. Despite this, Sillner found that most adults over the age of 65 years old, and their informal caregivers, are utilizing the technology assisted communication with their healthcare providers.

Sillner continues to explore preferences for technology assisted communication in individuals with Alzheimer’s disease, dementia, or cognitive impairment and their informal, family caregivers. Because these dyads have been historically excluded because of their lack of capacity to use technology, it is likely that older adults with dementia and/or cognitive impairment and their caregivers have unique needs that may be different than those without these conditions, she said.

“I think nurses in particular communicate uniquely with individuals and their family members in the realm of healthcare…” said Sillner. “I think understanding how to best personalize that communication is really important.”

With 2020 being the Year of the Nurse, Sillner said she believes it is important for nurses to continue to improve communication to individuals, families, and the larger public, especially with regards to the role of the nurse in healthcare. Similarly, the pandemic has undoubtedly emphasized the need for improved person-centered communication, as families now communicate with their loved ones in the hospital via virtual technology methods.

“We are seeing it [communication] in full force right now and I think we are seeing the importance of nurse-driven person-centered care, communication and what that means for all individuals, particularly in a time of a pandemic,” Sillner said.

Last Updated January 18, 2021