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The media often portrays the Internet as a phenomenon that isolates people from the outside world. But a California disease management company found that for elderly patients with congestive heart failure (CHF), the Internet helps them reconnect — not disconnect.
"CHF patients are often cut off from the outside world," notes Christine M. Ruggerio, RN, MSN, manager of clinical Web programs for LifeMasters Supported SelfCare in Newport Beach, CA. "This is especially true if they are using oxygen and can’t move around easily."
During a pilot program to deliver disease management and monitoring services to CHF patients using the Internet, LifeMasters found that the Internet can provide a vital lifeline that links house-bound patients to family and friends. "One patient used to teach. One of his former students saw an article about his old teacher participating in the Internet CHF program in a magazine, and started e-mailing him," says Ruggerio. "The old student told him he was now a successful man and that it was largely due to the inspiration of his old teacher. That man would never have known the impact he made on his students if it hadn’t been for the Internet program. Soon he was corresponding regularly with several of his old students via e-mail."
Eighty-three-year-old Jack Watt, who participated in the CHF trial, keeps in touch with his relatives on-line. "My granddaughter is away at college and we e-mail all the time. I also play around with investments on-line. The computer has been really positive for me."
Watt, who has participated in both the Internet and interactive voice response (IVR) disease management programs, prefers the Internet. "I put in my vital signs, and the Web site gives me a graph that shows how my vital signs compare to my past readings. It gives you a real sense of security." (See "Internet improves CHF outcomes, study shows," for information on the effectiveness of the Internet and IVR management programs for CHF.)
LifeMasters nurse Diva D’Allesandro, RN, says the Internet is an efficient disease management tool. "It provides patients more control over their vital signs entry than the IVR. If they make an error, they can easily correct it on the keyboard. If they make an error entering their vital signs on the IVR system, it shows up as an error, and we have to call the patient to clarify the data," she notes. "And, as Jack says, it provides instant feedback in a nice graph. The Internet provides more positive reinforcement than the IVR system."
Ruggerio can relate many examples of the Internet’s power to reconnect seniors house-bound by CHF with their friends and family. "I had one patient who told me he couldn’t sleep at night since his wife died," she recalls. "Now, when he can’t sleep, he gets up and uses the Internet to e-mail and do research. He says he no longer feels so alone at night."
Perhaps the most moving example was a woman who was devastated because her CHF progressed to the point she could no longer go to the senior center during the day to play Bridge. Ruggerio showed her how to play Bridge on-line, and she really enjoyed being able to continue playing the game she loved. "She also started to e-mail her son. She had lost touch with him and they hadn’t spoken for years," says Ruggerio. "From that first e-mail message, they developed a daily e-mail correspondence that continued to the day she died."
After the woman’s death, Ruggerio received an e-mail message from her son. "He e-mailed simply to say thank you. He was convinced they would never have built that bridge if she hadn’t had Internet access."
The seniors in the LifeMasters CHF Internet management program have been "an inspiration" for Ruggerio. "It brings me satisfaction and happiness to know that I was able to help do something that was so worthwhile. It’s wonderful to see these patients embrace this technology and take off with it."