Geriatric nursing focuses on providing specialized care for older adults, addressing their unique health challenges, maintaining functional ability, and promoting quality of life. This nursing diagnosis guide outlines common geriatric conditions, their assessment, and evidence-based interventions for optimal patient outcomes.
Causes (Related to)
Geriatric patients face multiple challenges that can affect their health status and quality of life:
Physical Factors:
- Age-related physiological changes
- Multiple chronic conditions (multimorbidity)
- Decreased muscle strength and mobility
- Sensory impairments (vision, hearing)
- Altered medication metabolism
Psychological Factors:
- Cognitive decline
- Depression and anxiety
- Social isolation
- Loss of independence
- Grief and loss
Environmental Factors:
- Fall hazards
- Limited access to resources
- Inadequate support systems
- Living alone
- Transportation difficulties
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Fatigue and weakness
- Pain in multiple sites
- Memory problems
- Difficulty sleeping
- Feelings of loneliness
- Decreased appetite
- Concerns about falling
- Difficulty with daily activities
Objective: (Nurse assesses)
- Decreased muscle strength
- Impaired balance and gait
- Cognitive function changes
- Weight loss or gain
- Poor medication compliance
- Signs of depression
- Decreased independence in ADLs
- Poor skin integrity
Expected Outcomes
Successful geriatric care management is indicated by:
- Maintained or improved functional status
- Prevention of falls
- Proper medication management
- Adequate nutrition and hydration
- Improved social engagement
- Enhanced quality of life
- Prevention of complications
- Maximum independence in ADLs
Nursing Assessment
Comprehensive Geriatric Assessment
- Physical function evaluation
- Mental status examination
- Social support assessment
- Environmental safety check
- Medication review
Functional Status Assessment
- ADL independence level
- Mobility and balance
- Use of assistive devices
- Fall risk evaluation
- Physical activity level
Cognitive and Mental Health Screening
- Memory assessment
- Depression screening
- Anxiety evaluation
- Social interaction patterns
- Sleep quality assessment
Nutritional Status
- Weight monitoring
- Dietary intake
- Hydration status
- Swallowing ability
- Appetite changes
Safety Assessment
- Home environment review
- Fall prevention needs
- Emergency response system
- Medication management ability
- Support system adequacy
Nursing Care Plans
Nursing Care Plan 1: Risk for Falls
Nursing Diagnosis Statement:
Risk for Falls related to decreased muscle strength, impaired balance, and environmental hazards as evidenced by unsteady gait and history of falls.
Related Factors:
- Age-related changes in balance
- Muscle weakness
- Visual impairment
- Multiple medications
- Environmental hazards
Nursing Interventions and Rationales:
- Conduct fall risk assessment
Rationale: Identifies specific risk factors and guides prevention strategies - Implement fall prevention measures
Rationale: Reduces risk of injury through environmental modification - Teach exercise programs
Rationale: Improves strength and balance
Desired Outcomes:
- The patient will remain free from falls
- The patient will demonstrate proper use of assistive devices
- The patient will identify and modify fall risk factors
Nursing Care Plan 2: Self-Care Deficit
Nursing Diagnosis Statement:
Self-Care Deficit related to decreased mobility and strength as evidenced by the inability to complete ADLs independently.
Related Factors:
- Physical limitations
- Fatigue
- Pain
- Cognitive impairment
- Depression
Nursing Interventions and Rationales:
- Assess the level of independence
Rationale: Establishes baseline and identifies specific needs - Provide assistive devices
Rationale: Promotes independence and safety - Teach energy conservation techniques
Rationale: Maximizes functional ability
Desired Outcomes:
- The patient will demonstrate increased independence in ADLs
- The patient will utilize assistive devices correctly
- The patient will maintain an optimal level of function
Nursing Care Plan 3: Impaired Memory
Nursing Diagnosis Statement:
Impaired Memory related to age-related cognitive changes as evidenced by forgetfulness and difficulty learning new information.
Related Factors:
- Age-related brain changes
- Medication side effects
- Depression
- Sleep disturbances
- Chronic illness
Nursing Interventions and Rationales:
- Implement memory aids
Rationale: Supports daily function and medication compliance - Establish routines
Rationale: Promotes consistency and reduces confusion - Provide cognitive stimulation
Rationale: Maintains mental function
Desired Outcomes:
- The patient will demonstrate improved memory function
- The patient will use memory aids effectively
- The patient will maintain safe medication management
Nursing Care Plan 4: Social Isolation
Nursing Diagnosis Statement:
Social Isolation related to decreased mobility and loss of social connections as evidenced by expressed feelings of loneliness.
Related Factors:
- Limited mobility
- Loss of peers
- Sensory deficits
- Transportation issues
- Depression
Nursing Interventions and Rationales:
- Assess support systems
Rationale: Identifies resources and needs - Facilitate social connections
Rationale: Reduces isolation and improves mood - Connect with community resources
Rationale: Provides opportunities for engagement
Desired Outcomes:
- The patient will report decreased feelings of loneliness
- The patient will increase social interactions
- The patient will participate in community activities
Nursing Care Plan 5: Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to decreased mobility and poor nutrition as evidenced by skin fragility and pressure areas.
Related Factors:
- Immobility
- Poor nutrition
- Incontinence
- Decreased sensation
- Chronic conditions
Nursing Interventions and Rationales:
- Perform regular skin assessments
Rationale: Early identification of skin breakdown - Implement pressure relief measures
Rationale: Prevents pressure injuries - Optimize nutrition and hydration
Rationale: Supports skin health
Desired Outcomes:
- The patient will maintain intact skin
- The patient will demonstrate proper skincare
- The patient will maintain adequate nutrition
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
- Garrard JW, Cox NJ, Dodds RM, Roberts HC, Sayer AA. Comprehensive geriatric assessment in primary care: a systematic review. Aging Clin Exp Res. 2020 Feb;32(2):197-205. doi: 10.1007/s40520-019-01183-w. Epub 2019 Apr 9. PMID: 30968287; PMCID: PMC7033083.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Jay S, Whittaker P, Mcintosh J, Hadden N. Can consultant geriatrician led comprehensive geriatric assessment in the emergency department reduce hospital admission rates? A systematic review. Age Ageing. 2017 May 1;46(3):366-372. doi: 10.1093/ageing/afw231. PMID: 27940568.
- Malik M, Moore Z, Patton D, O’Connor T, Nugent LE. The impact of geriatric focused nurse assessment and intervention in the emergency department: A systematic review. Int Emerg Nurs. 2018 Mar;37:52-60. doi: 10.1016/j.ienj.2018.01.008. Epub 2018 Feb 9. PMID: 29429847.
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
