{
  "name": "Geriatric Nursing (Older Adult)",
  "slug": "geriatric-nursing",
  "url": "https://nursingplex.com/care-plans/geriatric-nursing",
  "category": "Basic Nursing & General Care Plans",
  "summary": "Age-related changes in sensory, cognitive, skin and mobility status, plus polypharmacy and safety planning.",
  "nursing_diagnoses": [
    "Risk for falls",
    "Impaired skin integrity",
    "Social isolation",
    "Self-care deficit"
  ],
  "overview": [
    "Geriatric nursing addresses the normal changes of aging and their interaction with disease, medication and environment. Reduced physiologic reserve means older adults decompensate faster, present atypically, and recover more slowly from illness or hospitalization.",
    "Typical age-related changes include thinner and drier skin, reduced lean muscle mass, slowed gastric emptying, decreased renal clearance, blunted thirst, decreased baroreceptor response, presbycusis and presbyopia. None of these alone cause disease, but each narrows the margin for error.",
    "The nursing focus is functional: preventing falls, delirium, skin breakdown, adverse drug events, malnutrition and social isolation, while respecting autonomy and lifelong routines."
  ],
  "key_facts": [
    {
      "label": "Atypical presentation",
      "text": "Infection in an older adult may show as confusion, falls or anorexia without fever."
    },
    {
      "label": "Polypharmacy",
      "text": "Five or more medications sharply increases the risk of interactions, falls and delirium; review Beers-criteria drugs."
    },
    {
      "label": "Renal dosing",
      "text": "Serum creatinine may look normal despite reduced clearance because of low muscle mass — estimate GFR."
    },
    {
      "label": "Hospital hazards",
      "text": "Immobility, catheters, restraints and sleep disruption drive functional decline within days."
    }
  ],
  "nursing_priorities": [
    "Screen for falls, cognition, continence, nutrition, mood and function on admission.",
    "Prevent iatrogenic harm: delirium, deconditioning, pressure injury and adverse drug events.",
    "Preserve independence and mobility throughout the stay.",
    "Optimize sensory input with glasses and hearing aids.",
    "Support safe transitions of care and caregiver understanding."
  ],
  "assessment": {
    "subjective": [
      "Reports of dizziness, near-falls or unsteadiness",
      "Concerns about memory, loneliness or loss of independence",
      "Reports of poor appetite, difficulty chewing or limited food access",
      "Statements about difficulty affording or organizing medications"
    ],
    "objective": [
      "Orthostatic blood pressure changes",
      "Abnormal gait or Timed Up and Go greater than 12 seconds",
      "Low BMI, unintentional weight loss or poor dentition",
      "Fragile skin, bruising or early pressure areas over bony prominences",
      "Polypharmacy on medication reconciliation",
      "Abnormal cognitive or depression screening scores"
    ],
    "related_factors": [
      "Age-related sensory, musculoskeletal and cardiovascular changes",
      "Multiple chronic conditions and polypharmacy",
      "Social isolation, fixed income and limited transportation",
      "Unsafe home environment",
      "Cognitive impairment"
    ]
  },
  "goals": [
    "The client will remain free from falls and hospital-acquired injury.",
    "The client will maintain baseline functional ability at discharge.",
    "The client will maintain stable weight and hydration.",
    "The client will describe an accurate, simplified medication routine."
  ],
  "interventions": [
    {
      "title": "Prevent falls and functional decline",
      "points": [
        "Keep the bed low, call light in reach, non-skid footwear on and pathways clear.",
        "Mobilize at least three times daily unless contraindicated; avoid unnecessary catheters and lines.",
        "Perform orthostatic vitals before ambulation in patients on antihypertensives or diuretics.",
        "Use hourly rounding to anticipate toileting needs instead of restraints or alarms alone."
      ]
    },
    {
      "title": "Protect cognition and sleep",
      "points": [
        "Ensure glasses and hearing aids are worn and functional.",
        "Provide daylight exposure, orientation cues and family presence.",
        "Cluster night care to protect sleep and avoid benzodiazepines and anticholinergics."
      ]
    },
    {
      "title": "Skin, nutrition and medications",
      "points": [
        "Inspect skin every shift, reposition every two hours and use pH-balanced cleansers with moisturizer.",
        "Offer small frequent nutrient-dense meals, assist with feeding and monitor intake and weight.",
        "Reconcile medications, flag Beers-criteria drugs and simplify dosing schedules."
      ]
    }
  ],
  "patient_teaching": [
    "Review home fall-proofing: grab bars, lighting, removal of loose rugs.",
    "Teach rising slowly from lying to sitting to standing.",
    "Encourage protein and fluid intake even without thirst.",
    "Advise bringing a full medication list, including supplements, to every visit.",
    "Discuss immunizations, hearing/vision checks and community senior services."
  ]
}