Community Nursing Diagnosis for Elderly Care: Comprehensive Guide

Understanding Gerontology Nursing in Community Settings

Gerontology nursing, also known as geriatric nursing, is a specialized field dedicated to the care of older adults. It addresses the multifaceted needs of aging individuals, encompassing their physiological, developmental, psychological, socio-economic, cultural, and spiritual well-being. As the global population ages, the demand for expert geriatric care within community settings is increasingly critical. Community nursing plays a vital role in supporting elderly individuals to maintain their health and independence in their homes and familiar environments.

Effective community nursing for the elderly requires a holistic approach, recognizing that aging is a natural process accompanied by unique health challenges. Care should be delivered through a collaborative model, involving not only nurses but also families, community support systems, and an interdisciplinary healthcare team. This collaborative effort ensures that the expertise and resources of each member are leveraged to optimize the quality of life for older adults in the community. Geriatric community nursing care planning focuses on health promotion, disease prevention, safety enhancement, and the restoration and optimization of function within the community context.

Community Nursing Care Plans and Management for the Elderly

Community nursing care plans for geriatric patients are specifically designed to promote optimal health, independence, and quality of life for older adults living at home or in community-based settings. These plans emphasize comprehensive assessments conducted in the patient’s environment, addressing age-related changes and chronic conditions prevalent in the elderly population. A key focus is on fostering functional abilities and mobility within the community, ensuring medication management and safety in the home, and providing education on healthy aging practices tailored to community resources. Creating a safe and supportive home environment is paramount in community geriatric nursing care.

Prioritizing Nursing Problems in Community Elderly Care

In community settings, nursing priorities for elderly patients are adapted to the home environment and available resources. These priorities include:

Conducting thorough assessments within the patient’s home to develop individualized community-based care plans.
Managing chronic conditions common in older adults, such as diabetes, hypertension, and arthritis, within the community context and promoting cognitive health through home-based interventions.
Administering medications and treatments, including wound care and injections, in the patient’s home while ensuring medication safety and adherence in a non-clinical setting.
Providing education and support for healthy aging, including nutrition counseling, exercise programs tailored for home, and fall prevention strategies in the home environment.
Assisting with Activities of Daily Living (ADLs) in the home and promoting mobility and independence within the community.
Collaborating with interdisciplinary teams and leveraging community resources, such as senior centers, home health aides, and support groups, to provide comprehensive care.
Implementing fall prevention strategies specifically adapted to the home environment and ensuring a safe living space.
Offering emotional support, counseling, and connecting elderly patients and their families with community-based mental health services.

Community Nursing Assessment of Elderly Patients

Community nurses conduct assessments that are tailored to the home environment and the unique needs of elderly individuals living in the community. Assessments should include gathering both subjective and objective data, such as:

Reports of decreased mobility and difficulties navigating within the home and community.
Observable balance issues and increased risk of falls within the home.
Subjective reports and objective signs of changes in cognition or memory, impacting daily living at home.
Patient complaints of increased fatigue and reduced energy levels affecting community participation.
Changes in appetite and nutritional intake at home, potentially leading to weight loss.
Sleep disturbances and altered sleep patterns reported within the home environment.
Mood changes and signs of depression or anxiety impacting social engagement within the community.
Decreased vision or hearing affecting safety and communication within the home and community.
Increased vulnerability to infections and delayed wound healing, particularly relevant in home care settings.

Community Nursing Diagnosis Examples for Elderly Care

Formulating community nursing diagnoses for elderly care is crucial for developing targeted interventions in the home setting. These diagnoses are based on the nurse’s clinical judgment and a comprehensive understanding of the patient’s condition within their community environment. While nursing diagnoses provide a framework for care, their application is always individualized to the patient’s specific needs and the resources available in the community. Here are examples of community nursing diagnoses relevant to elderly care:

Risk for Falls related to environmental hazards in the home and decreased mobility.
Impaired Home Maintenance related to cognitive decline and physical limitations.
Social Isolation related to decreased mobility, sensory deficits, and lack of community engagement.
Deficient Knowledge regarding medication management and healthy aging practices in the community.
Risk for Imbalanced Nutrition: Less Than Body Requirements related to decreased appetite, social isolation, and limited access to healthy food options in the community.
Disturbed Sleep Pattern related to environmental factors at home and age-related physiological changes.
Risk for Infection related to chronic conditions, impaired skin integrity, and home environment factors.
Constipation related to decreased mobility, inadequate fluid intake, and medication side effects in the home setting.
Ineffective Coping related to chronic illness, social isolation, and lack of community support.
Self-Care Deficit related to physical limitations and cognitive decline impacting ADLs at home.

Setting Community Nursing Goals for Elderly Patients

Goals and expected outcomes in community nursing for the elderly are patient-centered and focused on improving their quality of life and independence at home. Examples of goals include:

The patient will remain free from falls within their home environment.
The patient and caregiver will implement home safety measures to prevent falls and injuries.
The patient will maintain adequate respiratory function, appropriate for their health condition, within their home environment.
The patient will maintain stable vital signs and mental status within their normal limits at home.
The patient will achieve adequate rest and maintain their cognitive function at their baseline level in their home.
The patient will re-establish a regular bowel pattern and manage constipation effectively at home.
The patient will demonstrate improved functional ability, maintain or gain weight as appropriate, and express a sense of hopefulness while living in the community.
The patient will swallow safely and prevent aspiration while eating and drinking at home.
The patient will maintain adequate hydration status and fluid balance within their home environment.
The patient will remain free from infection, demonstrating normal vital signs and mental status, while living at home.
The patient will maintain intact skin integrity and prevent pressure ulcers in their home environment.

Community Nursing Interventions and Actions for Elderly Care

Community nursing interventions are specifically adapted to be implemented in the patient’s home and community environment. These actions are designed to address the identified nursing diagnoses and achieve the established goals.

1. Promoting Home Safety and Preventing Falls & Injuries in the Community

Injury and fall prevention in the home environment is crucial for elderly patients in community nursing. Interventions include:

Conducting a comprehensive home safety assessment to identify fall risks. This involves evaluating lighting, flooring, stairs, bathroom safety, and furniture arrangement.
Modifying the home environment to minimize hazards. Recommendations include removing tripping hazards like rugs, improving lighting, installing grab bars in bathrooms, and ensuring clear pathways.
Providing assistive devices and training on their use. This may include walkers, canes, reachers, and devices to aid in dressing and bathing, ensuring they are appropriate for home use.
Educating patients and caregivers on fall prevention strategies and safe ambulation techniques within the home and community. This includes teaching proper footwear, safe transfer techniques, and medication safety related to falls.
Reviewing medication regimens to identify and minimize medications that increase fall risk. Collaboration with physicians and pharmacists is essential to adjust medications when possible.
Recommending regular eye and hearing exams and addressing sensory impairments. Ensuring patients have appropriate vision and hearing aids and use them consistently at home.
Connecting patients with community resources for home modifications and assistive devices. Providing information on local agencies and programs that can assist with home safety improvements.

Identify factors that increase fall risk specific to the patient’s home environment. Assess for clutter, poor lighting, uneven surfaces, and lack of safety equipment.

Assess the patient’s home environment for factors associated with increased fall risk. Evaluate the arrangement of furniture, accessibility of frequently used items, and the presence of hazards.

Monitor the patient’s cognitive status in the home setting and its impact on safety. Assess for confusion, disorientation, and memory impairments that could increase fall risk.

Utilize fall risk assessment tools adapted for home care settings. Employ validated tools to quantify fall risk and guide intervention planning.

Determine the cause of any acute confusion or changes in mental status in the home. Consider environmental factors, medication side effects, infections, or underlying health conditions.

Test short-term memory and orientation in the home environment to assess cognitive function related to safety. Observe the patient’s ability to follow instructions and recall safety information.

Assess for pain and its impact on mobility and fall risk in the home. Manage pain effectively to improve mobility and reduce the likelihood of falls.

Monitor intake and output, and hydration status, especially in hot weather or if the patient is at risk for dehydration at home. Dehydration can contribute to dizziness and falls.

Review all medications, including over-the-counter drugs, for potential side effects that increase fall risk. Pay attention to medications that cause dizziness, drowsiness, or orthostatic hypotension.

If the patient has short-term memory problems, establish routines and visual cues to promote safety in the home. Use checklists, labels, and reminders to aid memory and prevent falls.

Keep frequently used items within easy reach and organize the home environment for accessibility. Ensure pathways are clear, and items are stored at appropriate heights.

Ensure the patient wears glasses and hearing aids consistently in the home. Sensory aids are essential for safe navigation and communication.

Encourage family members to create a supportive and safe home environment. Involve family in home safety assessments and modifications.

Check on the patient regularly, especially if living alone or at high risk for falls. Regular home visits or phone check-ins can help monitor safety and address concerns.

Attempt to reorient the patient to their home environment as needed. Use familiar landmarks and cues to reinforce orientation and reduce confusion.

Provide music or familiar sounds to create a calming and orienting home environment. Avoid excessive noise or overstimulation that could increase confusion.

Tell the patient in simple terms about safety measures and instructions. Clear and concise communication is essential for patient understanding and adherence.

If the patient exhibits agitation or unsafe behaviors, assess the underlying cause and implement appropriate de-escalation techniques in the home. Ensure a calm and safe approach to managing behavioral issues.

If the patient has a cognitive deficit, simplify the home environment and remove hazards. Create a structured and predictable environment to minimize confusion and risk.

If the patient tries to leave the home unsupervised when it is unsafe, implement strategies to redirect and ensure safety. Develop plans to manage wandering behavior and ensure patient safety.

Have family members or caregivers stay with the patient as needed to ensure safety and supervision. Provide respite care resources for caregivers to prevent burnout.

If the patient tries to climb out of bed or furniture unsafely, ensure safe bed and furniture height and consider adaptive equipment. Adjust bed height and use furniture that is stable and appropriate for the patient’s needs.

Alternatively, if appropriate, place the patient in a safe and supervised area of the home during periods of high risk. Create a designated safe space within the home to minimize hazards.

Bargain with the patient and set realistic expectations for safety behaviors. Use positive reinforcement and encouragement to promote safe actions.

If the patient is attempting to remove medical devices or tubes, conceal them safely and use protective coverings. Minimize visibility of medical equipment to reduce patient interference.

Use medications cautiously for managing behavior and prioritize non-pharmacological approaches. Employ medication as a last resort and monitor for side effects.

Use restraints only as a last resort in emergency situations and according to ethical and legal guidelines. Prioritize less restrictive interventions and ensure proper monitoring if restraints are necessary.

Evaluate the continued need for safety interventions and adapt plans as patient condition changes. Regularly reassess and modify safety plans to meet evolving needs.

Secure identification bracelets or home safety alert systems as appropriate. Consider wearable devices for fall detection and emergency assistance.

Place assistive devices and commonly used items within easy reach in the home. Organize the home for maximum accessibility and convenience.

Review emergency protocols and ensure caregivers and family members are trained in emergency response. Prepare for potential emergencies and ensure everyone knows how to respond.

Keep the bed in the lowest position and use adjustable beds if appropriate. Bed height adjustments can enhance safety and ease transfers.

Answer calls for assistance promptly to prevent unsupervised ambulation. Respond quickly to patient needs and prevent unsafe independent movement.

Use bed rails or side rails as needed, especially at night or when the patient is confused. Bed rails can provide added safety, but use them judiciously and consider patient mobility.

Advise the patient to wear shoes or slippers with non-slip soles at all times in the home. Appropriate footwear significantly reduces slip and fall risks.

Orient the patient to their home surroundings regularly and maintain a consistent environment. Familiarity reduces confusion and improves safety.

Ensure the home is well-lit, especially at night and in hallways and bathrooms. Adequate lighting is critical for preventing falls, especially for elderly individuals with vision impairments.

Encourage family and caregivers to provide constant supervision and support, especially for high-risk patients. Caregiver presence and support are vital for safety.

Ensure the patient’s eyesight and hearing are regularly checked and corrected as needed. Sensory correction enhances environmental awareness and reduces risks.

Instruct the patient and caregivers on safe ambulation techniques and home safety measures. Provide ongoing education and reinforcement of safety practices.

Encourage regular exercise and gait training to improve strength, balance, and coordination. Physical activity improves mobility and reduces fall risk.

Collaborate with healthcare teams to review medications and identify those that may contribute to falls. Medication management is a key component of fall prevention.

Evaluate the need for physical and occupational therapy for home-based rehabilitation and safety training. Therapy services can improve function and safety in the home.

2. Improving Gas Exchange and Respiratory Function in the Home

Managing gas exchange and respiratory function in elderly patients at home requires specific adaptations:

Monitor respiratory rate, depth, pattern, breath sounds, cough, sputum, and mental status during home visits. Regular assessments are crucial for detecting respiratory changes.

Assess subtle changes in behavior or mental status that may indicate declining oxygen levels at home. Be alert for anxiety, disorientation, restlessness, and fatigue.

Auscultate lungs for adventitious sounds during home visits, considering the home environment and potential allergens. Assess for crackles, wheezes, or other abnormal sounds.

Encourage breathing and coughing exercises at home, tailored to the patient’s abilities and home setting. Teach techniques that can be easily performed at home.

Instruct on the use of incentive spirometry if applicable and appropriate for home use. Ensure the patient and caregiver understand proper use and maintenance of equipment.

Encourage increased fluid intake at home to promote secretion mobilization, unless contraindicated. Educate on hydration strategies and monitor fluid balance.

Manage fever promptly at home and provide comfort measures to reduce oxygen demand. Address hyperthermia and associated symptoms.

Teach the patient and caregiver about oxygen therapy and equipment if prescribed for home use. Ensure safe and effective oxygen administration in the home.

Connect patients with community resources for respiratory support and education. Provide information on pulmonary rehabilitation programs or support groups.

3. Managing Hypothermia Risks in the Home Environment

Hypothermia prevention and management at home are critical for elderly individuals:

Monitor temperature regularly, especially during cold weather or if the home environment is poorly heated. Use low-range thermometers if necessary and be aware of normal geriatric temperatures.

Assess and record mental status changes that may indicate hypothermia in the home. Look for disorientation, confusion, and lethargy.

Be cautious with sedatives, muscle relaxants, and hypnotics, as they can increase hypothermia risk at home. Minimize use and monitor for temperature changes.

Ensure adequate home heating and recommend appropriate clothing and blankets. Educate patients and caregivers on maintaining a warm home environment.

Provide blankets and warm clothing during home visits, especially if the patient is cold. Offer immediate warmth and comfort.

Initiate slow rewarming if mild hypothermia is suspected at home. Increase home temperature and use warm blankets.

Instruct on internal rewarming with warm oral fluids if appropriate and safe at home. Guide caregivers on safe rewarming techniques.

Watch for signs of excessive rapid rewarming and monitor vital signs closely at home. Be aware of potential complications during rewarming.

If temperature does not improve, consider underlying medical conditions and coordinate with the physician for further evaluation. Hypothermia may indicate underlying health issues.

Administer medications as prescribed for underlying conditions contributing to hypothermia. Treat infections, hypoglycemia, or hypothyroidism as directed.

4. Promoting Adequate Sleep and Improving Sleep Patterns at Home

Addressing sleep disturbances in elderly patients at home requires a focus on home routines and environment:

Assess sleep patterns at home, gathering information from the patient and caregiver about sleep routines and problems. Understand typical sleep habits and identify disruptions.

Inquire about activity levels and napping habits at home, as these impact nighttime sleep. Evaluate daytime activity and nap patterns.

Monitor activity levels and fatigue at home and adjust activity schedules to promote better sleep. Balance activity and rest to optimize sleep.

Identify typical nighttime routines at home and encourage their continuation. Maintain familiar bedtime rituals to promote sleep.

Arrange nursing activities to minimize sleep interruptions at home, consolidating tasks when possible. Reduce nighttime disturbances and cluster care activities.

Advise against caffeinated beverages, alcohol, and heavy meals close to bedtime at home. Educate on sleep hygiene practices related to diet and substances.

Promote a calm, quiet, and dark sleep environment at home. Optimize bedroom conditions for sleep.

Administer pain medications as ordered and provide comfort measures to enhance sleep at home. Manage pain and discomfort that interfere with sleep.

Recommend relaxation techniques and sleep aids appropriate for home use, if needed and prescribed. Explore non-pharmacological and pharmacological options as directed by the physician.

5. Restoring Bowel Function and Managing Constipation at Home

Managing bowel function and constipation in elderly patients at home focuses on dietary and lifestyle modifications:

Assess normal bowel elimination patterns at home during initial visits, including frequency, timing, and usual management strategies. Establish baseline bowel habits.

Quantify roughage intake and adjust dietary fiber gradually to manage constipation at home. Educate on appropriate fiber intake and sources.

Assess hydration status and encourage increased fluid intake at home to prevent constipation. Promote adequate hydration and monitor fluid balance.

Inform the patient about factors at home that may contribute to constipation and discuss preventative measures. Identify and address home-related constipation triggers.

Educate on the connection between fluid and fiber intake and bowel function at home. Reinforce the importance of diet for bowel health.

Instruct on including roughage in every meal at home, adapting to dietary preferences and tolerances. Provide practical dietary advice for home implementation.

Educate on the link between activity level and constipation and encourage regular exercise at home. Promote physical activity to stimulate bowel function.

Encourage using gastrocolic/duodenocolic reflexes to promote bowel movements, timing interventions with usual bowel habits at home. Individualize bowel management strategies.

Try previously effective non-pharmacologic measures at home before resorting to medications. Prioritize lifestyle and dietary interventions.

When pharmacologic therapy is needed, start with benign oral methods and escalate cautiously, following a stepped approach to laxative use at home. Minimize medication use and potential side effects.

Administer laxatives as ordered, especially after bowel imaging procedures performed in outpatient settings. Follow physician orders for medication management.

6. Addressing Failure to Thrive in Older Adults in the Community

Addressing failure to thrive in the community requires a holistic and interdisciplinary approach:

Conduct a comprehensive physical assessment at home, evaluating chronic disease conditions and functional status. Assess overall health and identify contributing factors.

Review laboratory studies and other relevant tests obtained in outpatient settings or home healthcare labs. Monitor key indicators of nutritional status and health.

Gather patient history, involving caregivers, to identify contributing factors to failure to thrive, such as social isolation, depression, or loss of appetite. Explore psychosocial and medical factors.

Allow the patient to express feelings and concerns about their health and living situation at home. Provide emotional support and address psychological needs.

Explain age-related changes and the concept of failure to thrive to the patient and family in a clear and sensitive manner. Educate on the complexities of the condition.

Collaborate with speech therapists and dietitians for home-based nutritional support and swallowing assessments. Address nutritional and swallowing issues at home.

Collaborate with physical and occupational therapists for home-based rehabilitation and functional improvement programs. Enhance mobility and ADL function in the home.

Connect with social services and community resources to address social isolation, financial needs, and end-of-life planning as appropriate. Provide access to community support systems.

7. Preventing Aspiration Risks in the Home Setting

Aspiration prevention at home requires caregiver education and adaptive strategies:

Evaluate swallowing reflex and gag reflex during home visits to assess aspiration risk. Perform basic swallowing assessments in the home setting.

Monitor food intake at home, observing consumption, chewing, swallowing, and any signs of difficulty. Assess mealtime behavior and identify potential problems.

Monitor the patient during swallowing at home, noting any coughing, choking, or wet voice sounds. Observe for signs of aspiration during meals.

Check for breath sound abnormalities, shortness of breath, or other respiratory changes that may indicate aspiration at home. Assess respiratory status for signs of aspiration.

Watch for food retention in the mouth or drooling, suggesting swallowing difficulties at home. Observe for signs of oral motor dysfunction.

Anticipate a video fluoroscopic swallowing exam (VFSE) or modified barium swallow exam (MBS) in an outpatient setting if aspiration risk is significant. Coordinate outpatient testing as needed.

Based on swallowing evaluations, implement prescribed dietary modifications such as thickened liquids or pureed foods at home. Adapt diet texture to reduce aspiration risk.

Anticipate the need for speech therapy services in the home or outpatient setting to address swallowing difficulties. Refer for specialized swallowing therapy.

Position the patient upright with head tilted forward during meals at home, if appropriate and tolerated. Use positioning techniques to enhance swallowing safety.

Ensure adequate rest before meals and a calm eating environment at home. Minimize distractions and fatigue during mealtimes.

Make sure dentures fit properly and are worn during meals at home. Proper chewing is essential for safe swallowing.

Instruct patients with dementia and caregivers on strategies to promote safe chewing and swallowing at home. Adapt feeding techniques for cognitive impairment.

Allow sufficient time for meals and provide a supportive and patient feeding environment at home. Avoid rushing meals and provide assistance as needed.

Encourage breathing and coughing exercises to maintain airway clearance and prevent aspiration complications at home. Promote respiratory hygiene.

Have suction equipment available at home if the patient is at high risk for aspiration. Prepare for potential aspiration emergencies in the home.

If aspiration occurs, follow emergency protocols and contact emergency services if necessary. Ensure caregivers are trained in emergency response.

Institute nothing by mouth (NPO) status if aspiration is suspected and consult with the physician for further evaluation and management. Prioritize patient safety in aspiration events.

8. Maintaining Fluid Balance in the Home Environment

Fluid balance management at home requires careful monitoring and education:

Assess and record fluid output at home, including urine, diarrhea, emesis, and other drainages. Monitor fluid losses and track output volumes.

Assess skin turgor and hydration status during home visits. Evaluate for signs of dehydration or fluid overload.

Monitor fluid intake at home and encourage adequate hydration (2-3 liters daily unless contraindicated). Promote fluid intake and set daily fluid goals.

Assess level of consciousness and mental status for signs of dehydration or fluid imbalance at home. Observe for cognitive changes related to hydration status.

Weigh the patient regularly at home, if feasible, to monitor fluid balance changes. Track weight fluctuations as indicators of fluid status.

Assess the patient’s ability to take fluids independently at home and provide assistance as needed. Ensure access to fluids and support self-hydration.

Monitor intake and output, especially for patients receiving home IV fluids or with conditions affecting fluid balance. Closely track fluid balance in at-risk patients.

If the patient is receiving home IV infusions, monitor for signs of fluid overload and adjust infusion rates as directed. Manage IV therapy safely in the home setting.

In dehydrated patients, monitor for changes in serum sodium, BUN, and creatinine levels through home blood draws or outpatient lab visits. Track lab values to guide rehydration strategies.

Ensure easy access to toilet facilities at home and assist with toileting as needed to promote fluid balance and prevent dehydration. Address toileting needs to support hydration.

Offer fluids frequently during home visits and encourage fluid intake throughout the day at home. Proactively promote hydration and offer preferred beverages.

9. Promoting Infection Control and Minimizing Infections in Home Care

Infection control in home care requires adapting strategies to the home environment:

Monitor baseline vital signs, including temperature, heart rate, respiratory rate, and mental status, during home visits, being aware of subtle signs of infection in the elderly. Detect early signs of infection in the home.

Assess skin integrity for breaks, redness, or ulcers during home visits and provide appropriate skin care at home. Prevent skin infections and monitor skin condition.

Monitor temperature using a low-range thermometer if needed and be aware of normal temperature ranges for older adults. Accurately measure temperature in the home.

Obtain rectal temperatures if oral readings are inconsistent or to confirm core temperature. Use appropriate temperature measurement techniques.

Avoid tympanic thermometers if accuracy is questionable in the home setting. Select reliable temperature measurement methods.

Assess urine quality and color, and monitor for urinary incontinence, which can indicate UTI in older adults at home. Detect urinary tract infections.

Limit urinary catheter use at home and promote catheter-free care whenever possible. Minimize catheter-associated infection risks.

Anticipate blood cultures, urinalysis, and urine cultures if infection is suspected, coordinating with outpatient labs or home health services. Arrange for diagnostic testing as needed.

Anticipate WBC counts and other lab tests to assess for infection severity and guide treatment. Monitor lab values to guide infection management.

If infection is confirmed, coordinate home IV fluid therapy and medication administration as prescribed. Manage infections effectively in the home.

Anticipate chest x-rays in outpatient settings if respiratory infection is suspected. Coordinate diagnostic imaging as needed.

Anticipate broad-spectrum antibiotics, antipyretics, and oxygen therapy as ordered for home management of infections. Implement prescribed treatment plans at home.

Educate patients and caregivers on hand hygiene, wound care, and infection prevention practices at home. Promote infection control measures in the home environment.

10. Preventing Pressure Ulcer Formation in Homebound Elderly

Pressure ulcer prevention for homebound elderly requires home-based strategies:

Assess skin condition upon initial home visit and regularly thereafter, paying attention to bony prominences. Monitor skin integrity and identify risk areas.

Monitor skin over bony prominences for erythema and signs of pressure injury during home visits. Detect early signs of pressure ulcers.

Observe skin for redness, texture changes, or breaks in skin surface during each home visit. Identify skin changes requiring intervention.

Use lift sheets or rolling techniques during repositioning at home to prevent shear injuries. Protect skin during transfers and repositioning.

Provide a turning schedule at least every two hours for bedbound or chairbound patients at home. Implement regular repositioning to relieve pressure.

Utilize pressure-redistributing mattresses, cushions, or overlays in the home setting if available and appropriate. Enhance pressure relief with specialized support surfaces.

Pad bony prominences with pillows or pads when patients are in bed or chair at home. Cushion bony areas to prevent pressure.

Use lotions generously on dry skin to maintain skin hydration and integrity at home. Moisturize skin to prevent dryness and breakdown.

Assist patients out of bed or chair as frequently as possible to promote mobility and pressure relief at home. Encourage movement and activity as tolerated.

Establish and communicate a turning schedule to family and caregivers at home. Ensure consistent repositioning and pressure relief.

Discourage placing tubes or objects directly under the patient that could cause pressure points at home. Avoid pressure from medical devices or equipment.

Use tepid water and mild, non-perfumed soaps for skin cleansing at home. Protect skin from harsh soaps and excessive heat.

Cleanse face, axillae, and genital areas daily and provide partial or complete baths as needed, considering skin dryness. Balance hygiene with skin health.

Record food intake and encourage adequate nutrition and hydration to support skin health at home. Promote nutrition for skin integrity.

Limit plastic protective pads and use cloth layers to absorb moisture and prevent skin maceration at home. Manage incontinence while protecting skin.

For incontinent patients, check and change pads frequently to maintain skin dryness at home. Prevent moisture-associated skin damage.

Recommended Resources for Community Geriatric Nursing

Recommended resources for community nursing diagnosis and care planning in geriatrics include:

Home Health Nursing: Scope and Standards of Practice. Provides guidelines for professional practice in home care settings.
Geriatric Nursing: Competencies for Care. Offers comprehensive information on geriatric care principles and practices.
Community/Public Health Nursing Practice: Health for Families and Populations. Covers community-based nursing approaches and population health.
Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care. (Ackley and Ladwig) – A valuable resource for evidence-based nursing diagnoses and interventions.
Nursing Care Plans – Nursing Diagnosis & Intervention. – Provides a wide range of care plans relevant to geriatric nursing.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales. – A quick reference tool for nursing diagnoses and interventions.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care. – A comprehensive manual for nursing diagnosis and care planning.
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health. – Includes care plans across various specialties, including geriatrics.

References and Sources

References and sources for community geriatric nursing care plans are drawn from established nursing textbooks, professional guidelines, and evidence-based practice resources in gerontology and community health nursing. Specific citations would be included in a formal academic paper or professional guideline document. This guide is intended for informational purposes and should be used in conjunction with professional nursing judgment and current clinical guidelines.

Facebook Email Copy Print Buffer Pinterest Share