The Golden Hour : Things To Look For When Checking On Your Aging Loved One

This episode is part of the Serious Illness series. We review the ADL needed for Golden Hour, Travel Difficulties, Weight Loss, Rest Periods and Sleeping in a Recliner. Issues with these may indicate there is a serious illness that is causing these problems.

The Golden Hour is typically the first hour of a patient's waking day, during which they should be able to perform their ADL's without too much trouble or requiring assistance.

The Activities of Daily Living (ADL's) are the basic functions a person might complete in the first hour each morning (The Golden Hour). ADL’s include Hygiene and Grooming, Eating, Dressing, Transfers, Toileting and Ambulating. Different and more complicated are (Instrumental Activities of Daily Living (IADL's), these consist of: Shopping, Housework/ Housekeeping, Finances/Banking, Food Preparation, Telephone/ other Communication, and Transportation. Needing assistance w/ IADL are not as likely to prevent someone from living alone as ADL issues. Being unable to safely complete ADL, may indicate an underlying serious illness that is keeping them from being independent. When a family member has difficulty traveling, whether it is just to the store or to meet friends for lunch or difficulty managing distant travel, there may be a serious illness causing it. Some patients have issues with coordinating travel because of the higher level executive function required to plan travel. For other people, it may be that there is an issue with the physical demands involved with travel. If there is a medical equipment issue that prevents patients from travel (wheel chair, oxygen, dialysis etc.) these types of things do indicate there may be a serious illness. Noticing weight loss may be concerning. Possibly a health issue or also just as concerning, the person may not be able to shop or possibly not able to prepare the food. If the person cannot get to the store or manage to have groceries delivered, they may be losing weight as they are struggling to even get groceries. Checking on the pantry stores and the foods in the refrigerator intermittently is a great gift of kindness for your loved one. Taking them on a little outing to shop once a month will give tremendous insight to how they function outside the home. Short outings are much better than long ones. If your loved one needs rest periods during the day, there may be a serious illness issue. If a person needs to rest more than they used to while performing routine tasks that they did not have issues with before, try to gently investigate what may be behind this. Look for increased need for sleep as well as needing to stop while performing an activity. Change in activity over time may indicate decline. Sleeping in a Recliner may indicate serious illness. There are many reasons to sleep in a recliner and some are more worrisome than others. There are risks involved w/ Recliner Sleep: joint immobility, falls, breathing and GI symptoms, or pain. Look into why the person is no longer able to sleep in a bed. Be mindful of feelings and be kind, don’t rush in and take over. Find ways keep them in their home and functional for as long as you can. Independence is important to people and many do not want to be a burden. Over time, you may need to provide more assistance and if you involve yourself early you will see how over time they need more assistance to remain safe.