key: cord-0906561-jw9dcgen
authors: Pham, Quynh; El-Dassouki, Noor; Lohani, Raima; Jebanesan, Aravinth; Young, Karen
title: The Future of Virtual Care for Older Ethnic Adults Beyond the COVID-19 Pandemic
date: 2022-01-07
journal: J Med Internet Res
DOI: 10.2196/29876
sha: b1c143708c1f12ad0367bfd1b0d79ee123578904
doc_id: 906561
cord_uid: jw9dcgen

The COVID-19 pandemic has fundamentally changed how Canadians access health care. Although it is undeniable that the rapid adoption of virtual care has played a critical role in reducing viral transmission, the gap in equitable access to virtual care remains pervasive for Canada’s aging and ethnocultural minority communities. Existing virtual care solutions are designed for the English-speaking, health-literate, and tech-savvy patient population, excluding older ethnic adults who often do not see themselves reflected in these identities. In acknowledging the permanency of virtual care brought on by the pandemic, we have a collective responsibility to co-design new models that serve our older ethnic patients who have been historically marginalized by the status quo. Building on existing foundations of caregiving within ethnocultural minority communities, one viable strategy to realize culturally equitable virtual care may be to engage the highly motivated and skilled family caregivers of older ethnic adults as partners in the technology-mediated management of their chronic disease. The time is now to build a model of shared virtual care that embraces Canada’s diverse cultures, while also providing its older ethnic adults with access to health innovations in partnership with equally invested family caregivers who have their health at heart.

Being partners in managing care can be a rewarding and challenging experience as you both work together towards a common goal: having the best possible survivorship experience. Having a care partner can improve a patient's quality of life, including their spiritual wellbeing and mental health. 1 Supporting a patient in their care can improve the caregiver's personal growth, perceived health, and overall well-being. 2 Review the following checklist together to strengthen your team as care partners: 3 ❏ Discuss both your needs and determine what you both are able and unable to do within your roles as a patient or caregiver ❏ Decide who will be responsible for the different aspects of care, such as printing or sending lab requisitions to the lab. This will help avoid confusion between you and your care partner. ❏ Work together to decide how openly you wish to communicate with one another about symptoms and your relationship ❏ Revisit your roles as care partners and level of communication on a regular basis, such as every 2 months ❏ Solve problems and plan for the future together ❏ Focus on short-term and achievable goals, such as substituting pop for water ❏ Recognize each other's accomplishments -co-managing care is difficult! ❏ Avoid blame and do your best to actively listen to each other ❏ Understand that there may be changes to your personal relationship:

❏ As the patient, be aware that your care partner will have access to your personal health information and this may result in feelings of loss of control. Remember -this is a normal feeling to have as you both work through your partnership roles. ❏ As the caregiver, recognize that you will have access to information you may not have had before and this may affect how you perceive your personal relationship. ❏ Remember that no team is perfect -honest, open, and clear communication will foster a more unified experience as you share care tasks

The goal of the Wellness Survey is to gather information on symptoms the patient may be experiencing. Some of the survey questions cover sensitive topics that you may find uncomfortable to discuss with your care partner.

As care partners, consider doing the following to ensure you receive the most appropriate care:

❏ Complete the Wellness Survey honestly so your doctor can help you manage your symptoms and track your progress most effectively. ❏ Approximately 1 week before your follow-up tasks are due, verify your responses to the Wellness Survey with one another to make sure the health information you will be submitting is correct. As a caregiver, try not to assume what the patient is experiencing. ❏ Show the patient how to complete the Wellness Surveys independently if they wish to do so. ❏ If applicable, care partners may work together to translate the Wellness Survey into the patient's native language. You may wish to ask the Ned Coordinator during your Welcome Visit or by emailing about using a cultural translator to assist with translating the survey.

Your doctor may sometimes schedule a virtual (video or phone) visit to discuss your progress with you. Keep the following in mind to make the most out of your virtual visits:

• Before your appointment, create a list of any questions or concerns you have. Bring them up at the end of your appointment if they were not addressed during the appointment. • The visit will be most effective if one speaker is speaking at a time. Wait for the doctor to prompt either one of you for questions or input before speaking. • To indicate a desire to speak during a video appointment, you may wish to use the "raise hand" function or type in the chat box.

• The patient must provide their consent before any account changes, like email or password changes, are made • Ned Clinic staff cannot control who you share password and security question information with • Depending on your past experiences as care partners, using Ned may cause the caregiver to feel a change in their level of responsibility with managing the patient's care • At any point, if the patient or care partner wishes to disengage as a team and the patient wishes to continue using Ned independently, please contact .

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