Functional Ability is Destiny at the End

This important article by Dr. Dhruv Khullar in the New York Times offers new insights from data mining about a critical tipping point for older adults who drift beyond having chronic illnesses to also developing functional ability deficits.  This lethal combination of pathology and diminished function creates “high needs” patients who have four times higher medical costs, more doctor visits, more use of home health services, and three times the likelihood of being hospitalized.

It also begs an expansion of the long term planning conversation beyond the standard query of “what will do when you can’t take care of your personal needs?”  It is now equally important to ask “what will you do proactively when the first hint of functional decline begins to invade your life?  Wait the tide or make a proactive more to shore up your independence?”  While early intervention has the potential to sustain quality of life, timing is everything…

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