The rationale for detecting deterioration in people with disabilities or older adults is multifaceted and rooted in improving health outcomes, quality of life, and healthcare efficiency. Here are the key reasons why early detection of deterioration is crucial for these populations:

Vulnerability to Rapid Health Changes

People with disabilities and older adults are often more susceptible to rapid health changes due to several factors:

• Complex health needs and multiple long-term conditions
• Weakened immune systems due to the ageing process
• Higher risk of comorbidities
• Frailty and physiological changes associated with ageing

Prevention of Adverse Outcomes

Early detection of deterioration can prevent or mitigate several negative consequences:

• Reduced risk of preventable deaths
• Fewer unplanned intensive care unit admissions
• Lower rates of hospital mortality
• Decreased likelihood of falls and other safety incidents

By identifying signs of deterioration early, healthcare providers can intervene before the condition worsens, potentially avoiding more serious complications.

Improved Quality of Care

Detecting deterioration promptly allows for:

• More effective and targeted interventions
• Proactive management of health conditions
• Personalised care plans tailored to individual needs
• Better coordination between different healthcare providers

This approach enhances the overall quality of care provided to people with disabilities and older adults.

Promotion of Independence

Early detection and management of deterioration can help maintain functional abilities and independence:

• Enables individuals to live longer in their own homes
• Reduces the need for premature moves to nursing homes
• Supports the concept of “ageing in place”
• Preserves autonomy and quality of life

Cost-Effectiveness

Timely recognition and response to deterioration can lead to significant cost savings:

• Reduction in avoidable hospital admissions
• Shorter hospital stays when admission is necessary
• More efficient use of healthcare resources
• Decreased burden on the healthcare system

Challenges in Traditional Assessment

People with disabilities and older adults may present atypically when experiencing health issues:

• Difficulty in communicating symptoms
• Potential for “diagnostic overshadowing” where symptoms are mistakenly attributed to the disability rather than a new health problem
• Subtle changes in behaviour or function may be the only indicators of deterioration
• Specialised tools and approaches are often necessary to effectively detect deterioration in these populations.

Empowerment of Caregivers and Family

Implementing systems to detect deterioration can:

• Provide peace of mind for caregivers and family members
• Enable remote monitoring of loved ones
• Facilitate timely communication with healthcare providers

This empowerment can lead to more collaborative and effective care management.

In conclusion, the rationale for detecting deterioration in people with disabilities and older adults is compelling. It encompasses improving health outcomes, maintaining independence, enhancing quality of life, and optimising healthcare resource utilisation. By focusing on early detection and timely intervention, we can significantly improve the care and well-being of these vulnerable populations.