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.
Nursing Care Plans
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 Impaired Skin Integrity
- Risk for Impaired Skin Integrity
Here are the risk factors for the nursing diagnosis Risk for Impaired Skin Integrity:
- Reduced subcutaneous fat and decreased peripherally capillary network in the integumentary system
- 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.
The commonly used expected outcomes or patient goals for Risk for Impaired Skin Integrity nursing diagnosis:
- The patient’s skin will remain nonerythremic and intact.
Nursing Interventions and Rationale
The following are sample nursing interventions and rationale (or scientific explanation) for the Risk for Impaired Skin Integrity that you can use for your geriatric nursing care plan:
|Assess the patient’s skin upon admission and regularly thereafter.||This assessment provides a baseline for succeeding assessments of skin integrity.|
|Monitor skin over bony prominences for erythema.||Skin that rests over the sacrum, scapulae, heels, spine, hips, pelvis, greater trochanter, knees, ankles, costal margins, occiput, and ischial tuberosities is at higher risk for skin breakdown due to excessive external pressures.|
|Observe skin for any areas of redness, changes in the texture or any breaks in the skin surface.||Redness or breaks in skin integrity require aggressive skin care measures to avoid additional breakdown and infection.|
|Use a lift sheet or roll the patient during repositioning.||Sliding, pulling, or dragging across sheets can result in shear injury.|
|Provide a turning schedule at least every two (2) hours.||Turning shuffles site of pressure and pressure relief.|
|Utilize waterbed, airbed, air-fluidized mattress, alternating pressure mattress, or other pressure-sensitive mattresses for older individuals who are unable to get out of bed or on bedrest.||These mattresses promote comfort and protect skin from injury produced by prolonged pressure.|
|Pad bony prominences with pillows or pads, even when the patient is up in a wheelchair or sits for long periods.||This measure keeps alternative positions and pads the bony prominences, hence protecting overlying skin. The ischial tuberosities are prone to breakdown when a patient is in the seated position. Gel pads for the chair or wheelchair sears help in disperse pressure.|
|Use lotions generously on dry skin.||Lotions provide moisture and can make skin smooth and supple. Lanolin-containing lotions are particularly helpful.|
|Assist the patient out of bed as frequently as possible. Amply utilize mechanical lifting devices to assist during patient’s transfers. If getting out of the bed is impossible, provide support with position changes every 2 hours.||These measures promote blood flow which can prevent skin breakdown.|
|Establish and provide a turning schedule on the patient care plan and at the bedside.||Schedule raises awareness of the nurses and significant others of turning schedule.|
|Discourage placing tubes under the patient’s head or limbs. Place a pad or pillow between the patient and the tube for cushion support.||Too much pressure from tubes can result in decubitus ulcer.|
|Use tepid water (32.2°-40.5°C [90°-105°F]) and super-fatted, nonperfumed soaps.||Hot water can burn older adults, who have diminished pain sensitivity and reduced sensation to temperature. Super-fatted soaps prevent skin dryness.|
|Clean the patient’s face, axillae, and genital areas daily.||Complete baths dry out the skin of an older adult and preferably performed every other day instead.|
|Record the percentage of food intake with meals. Allow the significant other to provide foods the patient likes. Recommend nutritious snacks as indicated. Collaborate with a dietician as needed for nutritional advice.||A diet that is high in protein and ascorbic acid protects the skin from breakdown.|
|Limit the use of plastic protective pads under the patient. When used, place at least one layer of cloth between the patient and the plastic pad to absorb moisture. For patients with incontinence, observe the pad at least every two (2) hours. Avoid use of adult diapers unless the patient is ambulatory, going for a diagnostic test, or is up in a chair.||Pad and diapers trap heat and moisture and can result in the breakdown of the skin (macerated associated skin damage).|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More care plans related to basic nursing concepts:
- Cancer (Oncology Nursing) | 13 Care Plans
- End-of-Life Care (Hospice Care or Palliative) | 4 Care Plans
- Geriatric Nursing (Older Adult) | 11 Care Plans
- Prolonged Bed Rest | 8 Care Plans
- Surgery (Perioperative Client) | 13 Care Plans
- Systemic Lupus Erythematosus | 4 Care Plans
- Total Parenteral Nutrition | 4 Care Plans
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]