Predicting when someone will become dependent on others for assistance with activities of daily living is no more accurate than predicting the weather. The “watch” vs “warning” prediction model for the weather is useful, however, in the long-term care context.
A “watch” is issued when a family begins to notice mild changes in a loved one’s mental or physical condition that may affect their ability to remain independent with activities of daily living. Trends to watch include noticeable confusion, an active person becoming sedentary, unsteady gate or while transferring, and social withdrawal.
A “watch” becomes a “warning” when the loss of independence with one or more activities of daily living is probably going to occur. Trends to look for include a decline in a decision-making capacity, an early diagnosis of a chronic medical condition such as Parkinson’s or dementia, incontinence, dependence on a walker or cane, falling, and one or more hospitalizations requiring inpatient rehab in a given year. The transition from independence to requiring assistance often takes place suddenly.
The question is, when does the family begin to prepare for a loved one’s predictable decline from independence? Just because the sun is out on the beach when the hurricane warning is issued, does not mean that landfall will not occur on your beach.
