Older adults can lead an independent and active life and then experience a sudden functional decline. You should be aware of the warning signs that may signal a decline in functionality and have knowledge of the appropriate sources of assistance in the event of a significant change. We have gathered information on warning signs and strategies for managing them.

Which conditions warrant a referral to a physician

If there has been an abrupt or swift change (within hours or days) in physical or mental function, urgently consult your family physician. to diagnose the underlying causes of the issue and initiate appropriate treatment.

The problem may be an acute disease, characterized by a decline in function, such as post-COVID-19 inflammation or the exacerbation of underlying diseases like Osteoporosis, etc.
In such conditions, it is recommended to seek treatment from your family physician.

If functionality is not improving after recovering from the disease, and if there is no improvement in the medical condition, it is recommended to obtain a referral from your family physician to a geriatric specialist.

If the change is gradual and continues for weeks and even months, it is important to refer to the family physician to obtain a referral for the following tests for a comprehensive general assessment:

• Blood count.
• A thyroid function test to measure your hormone levels.
• Iron values.
• Vitamin B12.
• Folic acid.
• Renal functions.
• Blood sodium.

Conditions which require urgent hospital admission

• Pneumonia.
• Cerebrovascular accident (stroke).
• Risk situations such as dehydration caused by reduced fluid intake or hot weather.
• Changes associated with medication therapy.

In some conditions, the family physician will refer the patient to a geriatric specialist, particularly if there is an unexplained functional decline that cannot be accounted for by blood tests, accompanied by memory decrease, a cognitive decline or depression symptoms.

Further inquiries that should be conducted when there is a decline in functionality

• Nutrition: Has your dietary intake lessened lately, resulting in decreased calorie and nutrient consumption? (In an extreme scenario, only a cup of tea and a slice of bread).
• Fluids: Do you drink enough fluids?
• Medications: Has there been a discontinuation of regular medication? Or have doses of regular medication been forgotten? Have you recently started any new medications, including food additives or over-the-counter drugs without informing your physician? Have you taken medication in a high or improper dosage? Has there been a change in the consumption of sleeping pills or tranquilizers? It is important to inform your family physician about any changes in medications and food additives, as the combination of certain food additives and medications may potentially harm your health.
• Mental and social factors: Have you recently encountered any changes or events that may have led to a crisis, such as a death of a loved one?