Navigating the digital shift: training and challenges in telerehabilitation for elderly care. A qualitative study

Europe is currently experiencing a demographic transformation, leading to a progressive increase in the elderly population and a consequent change in their health and care needs. It is crucial for health professionals to be aware of these changes and fully equipped to address their patients' new and different needs. This phenomenon is particularly critical in Italy due to a notably low mortality rate and an equally low birth rate. The trend of an aging society affects the lives of older people and their families and has broader, destabilizing effects on society. The urgency and importance of addressing this issue cannot be overstated. Furthermore, the advent of the SARS-CoV-2 pandemic has prompted a reorganization of the National Health Service and the accelerated digitization of healthcare through the development of ITC. All these factors have led to a notable increase in the utilization of telecommunication devices across diverse domains, including the care of elderly patients through telemedicine practices, particularly telerehabilitation (TR). This contribution presents preliminary findings from an ongoing qualitative research study. The study aims to explore the educational, training, and support needs of elderly individuals, their caregivers, and healthcare professionals concerning the use of remote rehabilitation services. The study, titled "APCARE.TE" (The perspective of the elderly, health professionals, and caregivers on telerehabilitation: A qualitative study), uses a qualitative methodology to critically examine the role of training in the successful implementation of telerehabilitation projects. It emphasizes that while technical skills training is necessary for all stakeholders, it's just one aspect of a larger approach that also requires a reevaluation of practices and the therapeutic relationship when utilizing technologies. This presents potential benefits and new opportunities. To ensure inclusivity with emancipatory effects and to prevent an increase in the digital divide and technological exclusion, especially among the elderly, it's crucial to conceptualize TR as a complex socio-material practice. This involves a combination of human and non-human elements that affect various aspects of everyday life and care. After analyzing interviews with rehabilitation professionals, we found that distance rehabilitation, including synchronous, asynchronous, and blended approaches, requires significant changes in the actions, roles, and interventions of rehabilitation therapists, as well as their relationships with patients, work settings, and organizations. The data suggests that a new perspective on training methods is necessary. Moreover, reflective practices that aid comprehension of the processes involved in TR should be encouraged among healthcare professionals, patients, and caregivers.