Needs attention todayToday, 6:40 am
Overnight pattern has changed sharply
Bathroom trips between 11pm and 6am have averaged 3.4 per night for six nights, against her learned baseline of 1.4.
Care team · caseload
Tomás Reyes, RN
Sixty households, one nurse. This view exists so the consumer product does not become sixty more dashboards nobody reads — it ranks by who moved against their own baseline, and puts the reason on the row.
Households
60
Across the Asheville panel
Need attention today
2
Down from 5 on Friday
Watch list
11
Reviewed at the Monday huddle
Stable
47
No action required this week
Ranked by change, not by score
A household sitting low but flat is less urgent than one sitting higher and falling. Trajectory is what forces a move out of the home.
| Household | Score | 14-day change | Why it surfaced | Status |
|---|---|---|---|---|
| Eleanor Whitfield78 | 69 | ↓ 11.8 pts | Overnight pattern + appetite + weight loss cluster | Act today |
| Harold Pines84 | 61 | ↓ 4.2 pts | Two near-falls detected in the hallway this week | Act today |
| Ruth Delacroix81 | 69 | ↓ 2.1 pts | Medication adherence down to 78% | Watch |
| Walter Nkemelu76 | 74 | ↓ 1.4 pts | Isolation screening moved to moderate | Watch |
| Bettina Králova79 | 88 | ↑ 2.6 pts | Recovering well after the hip revision | Stable |
| Sam Ortiz73 | 91 | → steady | Stable across all domains | Stable |
Eleanor Whitfield · clinical summary
78 · lives alone · Type 2 diabetes · Hypertension · Osteoarthritis (left knee) · Mild hearing loss
Mobility & stability70
base 84↓ 14.0 pts
Sleep quality64
base 80↓ 13.7 pts
Nutrition & hydration66
base 81↓ 11.0 pts
Medication adherence81
base 92↓ 10.3 pts
Social connection59
base 75↓ 15.3 pts
Vitals70
base 77↓ 4.3 pts
Copilot summary
Post-operative day 11 following left TKA. Four domains declining in a correlated cluster over eighteen days. Nocturia three-fold above baseline, unintentional 3.1 lb loss, fasting glucose elevated 15–22 mg/dL, resting heart rate 11–14 bpm above baseline for five nights, and appetite suppression — with blood pressure, wound appearance and fall count unchanged. Recovery-task adherence remains excellent at 98%, which argues against low motivation or depression as the driver. The pattern is more consistent with an infectious cause than with the surgical recovery itself. Suggest urinalysis before adjusting analgesia. Stay-in-place confidence 58%, down from 84% on Jul 19.
Generated summary, grounded in her record and the connected clinical sources. Clinical decisions remain with the care team; this is a prompt to look, not a diagnosis. Ask Grace for the reasoning behind any line.
Recent private duty visits
Caregiver notes from the household.
Denise Aguilar · Fri Aug 7
Made the salmon and quinoa from the plan; she ate about two-thirds, which is more than she told me she would. Took the evening metformin while I was there. Knee clearly bothering her on the stairs — she held the rail with both hands going down.
Joanne Pruitt · Wed Aug 5
Groceries put away. She didn't want to come along to the store this time, first time that's happened. Sat and had tea instead.
Open signals
Worth a lookToday, 7:15 am
Four dinners skipped in seven days
Kitchen motion is down 59% against baseline and evening meals are going unprepared. Protein intake is averaging 42g against a 68g target.
Worth a lookYesterday, 8:02 pm
Walking pace down 19%, sitting time up
Hallway transit is slower and more hesitant, and time seated in the living room is up 2h 10m per day.
Conversations
Clinical threads write to the chart. Peer threads do not — that separation is what makes the informal ones usable.
Clinical
Written to the chartDr. Priyanka Shah
Orthopaedic surgeon · Mission
Whitfield, E. — possible post-op UTI
“Agree, get the sample before we touch the analgesia. Copy me on the result.”
Today, 10:22 am · in the chart
- 1 new
Ana Petrova, RD
Dietitian
Whitfield, E. — 3.1 lb loss
“I've moved her review up to Wednesday. Can you send the 14-day intake record?”
Today, 9:05 am · in the chart
Case managers
Not chartedNadia Okonkwo, RN
Case manager · north panel
Second opinion
“Seen this exact cluster twice this month post-TKA. Both were UTIs. Trust the pattern.”
Today, 9:48 am
- 2 new
Weekend cover
3 case managers
Handover — Sat 15th
“I'll flag Whitfield and Pines as the two to watch. Notes in by Friday 4pm.”
Yesterday, 5:30 pm
Household
Family & carersSarah Whitfield-Ruiz
Daughter · primary contact
Sample collection + Wednesday review
“Book it for Wednesday afternoon — results should be back by then.”
Today, 9:36 am · in the chart
Denise Aguilar
Private duty caregiver
Evening shifts — what to watch
“Noted. I'll write down exactly how much of the dinner she eats each night.”
Yesterday, 6:40 pm