Jump to content

Elder abuse care plan

Posted

Hi, I am working this semester building care plans for home care nurses to intervene on cases of elder abuse and neglect. I working on nursing diagnoses (using NANDA labels). I am usually really good at these, but seem to be falling flat. My patient (not a real person, but a simulated character) was a 77 y/o Caucasian female with a past medical hx of A fib, Alzheimer's dementia, and wandering. She is living with her divorced daughter who works full time during the day. Pt is locked in the house as a safety measure to prevent wandering and is put in a diaper. The bathroom door is locked to prevent the mother from "flooding it". Pt stays in her diaper all day and is not able to provide her own peri-care. The daughter is verbally abusive, but there are no signs of physical or sexual abuse. Daughter is clearly under caregiver strain. Pt is responsible for her meds (Digoxin and Anceph), does not track her compliance with drug treatment. Daughter does provide a ride to doctor appointments and handles the finances. Pt is malnourished, dehydrated, and frail. Has expressed wanting to be more social and misses going to church.

Currently, I have done a diagnosis for social isolation/risk for loneliness, and I want to address the abuse more than some of the other obvious dx (i.e. nutrition

Do you not have the NANDA-I 2015-2017, the most current edition? Instant download for your Kindle or iPad, or hard copy at Amazon. Get it stat. (I prefer the hard copy, YMMV)

You can't do much without it, because all the "handbooks" work of the medical diagnosis, and although you have some there, you are perceptive to intuit that there are other priorities. Suggest you take a look at things from a more nursing-centric perspective, particularly at

*Domain 4, Activity and rest

*Domain 5, Perception/cognition

*Domain 7, Role relationships (think about "caregiver role strain" and the other ones related to family processes and social interaction)

*Domain 9, Coping/stress tolerance (patient and daughter)

*Domain 10, Life principles (spiritual distress issues)

*Domain 11, Safety (many risk factors here, by the sounds of things)

*Domain 12, Comfort (loneliness, isolation)

I am using Nursing diagnosis applications to clinical practice (14th ed 2013) by Carpenito so it's still "x diagnosis" r/t this s/t that AEB these things. I have not used or instructed to use the new NANDA-I 2015-2017. Thanks for the feedback though. I will look this book up.

It is ALWAYS OK to use more resources.

Any book published in 2013 was written in 2011, possibly 2012, so its basis in nursing diagnosis is not the current one. The 2009-2011 NANDA-I has had several nursing diagnoses withdrawn for lack of evidence (you can read all about it when that happens in subsequent editions).

Not sure what "s/t" stands for. Diagnosis, related to whatever, as evidenced by (evidence).