In this nursing care plan guide are 11 nursing diagnosis for the care of the elderly (older adult) or geriatric nursing or also known as gerontological nursing. Learn about the assessment, care plan goals, and nursing interventions for gerontology nursing in this post.
Gerontology nursing or geriatric nursing specializes in the care of older or elderly adults. Geriatric nursing addresses the physiological, developmental, psychological, socio-economic, cultural and spiritual needs of an aging individual.
Since aging is a normal and fundamental part of life. Providing nursing care for elderly clients should not only be isolated to one field but is best given through a collaborative effort which includes their family, community, and other health care team. Through this, nurses may be able to use the expertise and resources of each team to improve and maintain the quality of life of the elderly.
Geriatric nursing care planning centers on the aging process, promotion, restoration, and optimization of health and functions; increased safety; prevention of illness and injury; facilitation of healing.
Here are 11 nursing care plans (NCP) and nursing diagnosis for geriatric nursing or nursing care of the elderly (older adult):
- Risk for Falls
- Impaired Gas Exchange
- Disturbed Sleep Pattern
- Adult Failure to Thrive
- Risk for Aspiration
- Risk for Deficient Fluid Volume
- Risk for Injury
- Risk for Infection
- Risk for Impaired Skin Integrity
Risk for Falls
Common risk factors for the nursing diagnosis risk for falls:
- Age (especially ≥ 65 years)
- Impaired physical mobility
- Loss of muscle strength
- Altered sensory perception
- Presence of illness (Alzheimer’s disease, dementia, osteoporosis)
- Urinary incontinence
- Use of medications
- Lack of knowledge of environmental hazards secondary to confusion
- Improper use of aids (e.g., canes, walkers, wheelchair, crutches)
- Not applicable for risk diagnosis. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.
Expected outcomes or patient goals for risk for falls nursing diagnosis:
- Patient will be free from falls.
- Patient and caregiver will implement measures to increase safety and prevent falls in the home.
Nursing Interventions and Rationale
In this section are the nursing actions or interventions and their rationale or scientific explanation for the nursing diagnosis risk for falls:
|Identify factors that increase the level of fall risk||These factors will help in determining interventions necessary for the patient. Risk factors include age, presence of an illness, sensory and motor deficits, medication use, and inappropriate use of mobility aids.|
|Assess the patient’s environment for factors associated with an increased risk for fall.||A patient who is not familiar with the placement of furniture in an area or who has inadequate lighting in the house increases the risk for falls.|
|Secure a wristband identification to warn healthcare providers to implement fall precaution on the patient.||Healthcare providers need to recognize patients at high risk for falls to implement measures to promote patient safety and prevent falls.|
|Place assistive devices and commonly use items within reach.||Provides easy access to assistive devices and personal care items. Items such as call bell, telephone, and water should be kept close to avoid frequent reaching.|
|Review hospital protocols regarding transferring a patient.||Hospital facility should have clear policies and procedures during transfers that will ensure the patient’s safety.|
|Keep the patient’s bed in the lowest position at all times.||Keeping the bed closer to the floor prevents injury and risk of falls.|
|Answer call light as soon as possible.||This is to prevent an unstable patient from ambulating without any assistance.|
|Use side rails on bed as needed||Raising the side rails reduces the risk of patients falling out of bed during transport.|
|Advise the patient to wear shoes or slippers with non-slip soles when walking.||Wearing non-slip footwear help prevents slips and falls.|
|Orient the patient to the surroundings. Avoid re-arranging the furniture in the room.||The patient should be familiarized with the bed, location of the bathroom, furniture, and other environmental hazards that can cause older patients to trip or fall.|
|Ensure the patient’s room is well-lit. Consider the use of a bedside lamp that is turned on at night.||Providing lighting in key places can reduce fall risk and avoid obstacles during mobility.|
|Encourage the family and other significant others to stay with the patient at all times.||Prevents the patient from accidentally falling or pulling out tubes.|
|Ensure the patient’s eyesight is regularly checked and explain the importance of wearing eyeglasses if needed. Make sure glasses and hearing aids are always worn.||Hazard can be lessened if the patient utilizes appropriate aids to improve visual and auditory orientation to the environment. Visually impaired patients are at high risk for falls.|
|Instruct the patient how to ambulate at home, including using safety measures such as handrails in the bathroom.||Help relieve anxiety at home and eventually decreases the risk of falls during ambulation.|
|Encourage the patient to engage in a program of regular exercise and gait training.||Exercises can improve muscle strength, balance, coordination and reaction time. Physical conditioning reduces the incidence of falls and avoids injury that is sustained when a fall happens.|
|Collaborate with other health care team to assess and review patient’s medications that can contribute to the risk for falls. Identify the peak effects of the medications that can alter the consciousness of the patient.||A review of the patient’s prescribed medications will recognize side effects and drug interactions that may enhance fall injury risk. The more medications a patient takes, the greater the risk for side effects and interactions such as orthostatic hypotension, dizziness, confusion, urinary incontinence, and altered gait and balance. Polypharmacy in older adults is a significant risk factor for falls.|
|Evaluate the need for physical and occupational therapy to assist patient with gait techniques and provide the patient with assistive devices for transfer and ambulation. Initiate a home safety evaluation as needed.||The use of gait belts provides a more secure means to safely assist patients when transferring from bed to chair. Assistive aids such as wheelchairs, canes, and walkers allow the patient to have stability and balance during ambulation. High toilet seats can facilitate safe transfer on and off the toilet.|
References and Sources
Here are the references and sources for this Geriatric Nursing Care Plan:
- Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016). Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company.[Link]
- Carpenito-Moyet, L. J. (2009). Nursing care plans & documentation: nursing diagnoses and collaborative problems. Lippincott Williams & Wilkins. [Link]
- Gilje, F., Lacey, L., & Moore, C. (2007). Gerontology and geriatric issues and trends in US nursing programs: a national survey. Journal of Professional Nursing, 23(1), 21-29. [Link]
- Mauk, K. L. (Ed.). (2010). Gerontological nursing: Competencies for care. Jones & Bartlett Publishers. [Link]
- Wold, G. H. (2013). Basic Geriatric Nursing-E-Book. Elsevier Health Sciences. [Link]