Faculty voice:

Sandra Spoelstra: Sleeping with your iPhone

April 30, 2014

Sandra L. Spoelstra is an assistant professor in the College of Nursing who researches health topics such as physical function and falls across the cancer trajectory, long-term care in the community setting, fall prevention and voice and text messaging to promote treatment adherence.

Do you sleep with your iPhone? My aunt does and I want to tell you about her. I am a nurse and research scientist. My passion is helping the elderly, especially those who have had cancer, have a better quality of life.

My aunt is 85 years old and had cancer years ago. After treatment, the nerves in her legs were damaged, so she wears braces and is in a wheelchair. Like most people, her goal is to continue living in her home independently. She loves her iPhone and keeps it within reach at all times so she can stay connected to family and friends and even sleeps with it every night. If she falls she can call for help, when she needs a prescription refilled she calls her pharmacy and, most importantly, she can see pictures of all her grandchildren on Facebook.

It got me thinking. How could we use an iPhone or iPad to help elderly people with cancer? Do the elderly have smart phones and Internet connection? Do they text message or only talk on their phones? Could they view information on the smaller size screens?

It got me thinking further. Could clinicians send text message reminders to promote medication adherence, prompt attendance at appointments, and to promote preventive care? Could we send a text message to motivate people to do physical activity or improve nutrition? Could we direct patients to websites to obtain information to help manage at home?

This led to our current project, text messaging cancer patients. We encourage patients to manage their symptoms from side effects of treatment. We do this because if their symptoms become too severe they might have to stop treatment. We also remind them to take their cancer pills. We have found that patients like the text messages, and even if they did not need a reminder to take their pills, it made them feel that someone was watching over them. We believe a text message may have advantages over a phone call or email, because it is unobtrusive, can be answered when you feel like it, yet remains on your phone until you read or delete it. Most importantly, it prompts engagement in action to improve health outcomes.

Why is this important? Previously, cancer treatment was always given intravenously, and patients went to the clinic and were observed by nurses and could talk to them about their problems. Now, much of cancer treatment is in pill form, and patients take care of themselves at home. Text messages seem to help patients better understand what to do and when to contact their oncologist.

Now that we know elderly cancer patients text message, we can begin to think about text messages for other needs. We can also explore how an iPad could be used to enhance care at home. The number of people who have cell phones and can text message is growing exponentially, and smart phones are predicted to become the health tool of the future. It is very exciting to be part of this change.