You are a home health care nurse visiting the home of an 86-year-old retired waitress to determine what alterations may need to be made to her environment. She was recently discharged from a rehabilitation facility where she received therapy after her stroke.

QUESTION

You are a home health care nurse visiting the home of an 86-year-old retired waitress to determine what alterations may need to be made to her environment. She was recently discharged from a rehabilitation facility where she received therapy after her stroke. She greets you at the door of her one-story house, proudly sharing that she has lived there for 65 years. Following her inside, you note that she exhibits minimal left-sided weakness but ambulates with a quad cane. You observe a clean but cluttered home with many pictures and memorabilia of her extensive family. Scattered throughout the home are colorful throw rugs, which she indicates help cover the stains from “accidents” of her two cats and one small dog, who seem devoted to her and follow her every move. As you visually scan her kitchen, you note her several medication bottles scattered throughout. In her bedroom, you note two electrical outlets to which are connected an alarm clock, a radio, a small television, a telephone and detached answering machine, an air conditioner, an oscillating fan, and her cell phone charger. Due to her extensive appliance use within her bedroom, you observe three extension cords crossing the room to connect to the outlets.

a. List data pertinent to your safety assessment.

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b. How might her safety be jeopardized by objects within her home?

c. Detail potential strategies to increase her ambulation safety.

d. How might she increase her safety in her kitchen?

e. Outline strategies that could increase her safety in her bedroom.

ANSWER

Promoting Home Safety for an Elderly Stroke Survivor: Key Considerations and Strategies

Introduction

Ensuring a safe environment is crucial for the well-being and independence of elderly individuals, particularly thos e who have experienced a stroke. As a home health care nurse visiting an 86-year-old retired waitress who recently had a stroke, it is essential to assess her home environment for potential safety hazards. This essay will discuss pertinent data from the assessment, highlight objects within her home that may jeopardize her safety, and provide strategies to increase her safety in both ambulation and specific areas like the kitchen and bedroom.

Data pertinent to the safety assessment

Minimal left-sided weakness: Understanding her physical limitations is essential to determine potential safety risks and requirements for assistance or adaptive devices. b. Ambulation with a quad cane: Her reliance on a quad cane indicates the need for stability and support during walking, further emphasizing the importance of a safe living space. c. Clean but cluttered home: The presence of clutter can increase the risk of tripping and falling, particularly for someone with limited mobility or balance issues. d. Colorful throw rugs: While serving to cover stains, these rugs may become tripping hazards if they slip or bunch up, especially considering her minimal left-sided weakness (Lam, 2007). e. Scattered medication bottles: Disorganized medication storage can lead to errors in medication administration, potentially compromising her health and well-being. f. Pets (two cats and one small dog): While these animals provide companionship, their presence increases the risk of tripping, especially if they frequently follow her around.

Safety risks posed by objects within her home

Clutter: The cluttered home environment can impede safe movement, hinder mobility aids, and increase the risk of falls. Removing unnecessary items and organizing essential belongings will help mitigate these risks. b. Throw rugs: Although the colorful throw rugs are intended to cover stains, they pose a hazard as potential tripping or slipping points. Replacing them with non-slip rugs or securing them to the floor would greatly reduce the risk of accidents. c. Medication bottles: Scattered medication bottles can lead to confusion, potentially resulting in medication errors. Implementing a centralized and labeled medication storage system, such as a pill organizer or medication cabinet, will promote proper medication management.

Strategies to enhance ambulation safety

Remove clutter: Clearing pathways and eliminating unnecessary items will create a safer environment, allowing for unobstructed movement with the quad cane. b. Install handrails: Placing handrails in key areas such as hallways, staircases, and the bathroom can provide additional support and stability during ambulation. c. Proper lighting: Ensuring adequate lighting throughout the home, including stairways and entranceways, can prevent falls caused by poor visibility.

Increasing safety in the kitchen

Organize medications: Store medications in a dedicated area away from food items and ensure they are properly labeled (“Radiation, Lab, and Drug Hazards,” 2014). This will minimize the risk of medication errors and accidental ingestion. b. Install grab bars: Placing grab bars near the stove, sink, and countertops can offer stability and support while performing daily tasks, reducing the risk of falls. c. Use non-slip mats: Placing non-slip mats near the sink and stove area will minimize the risk of slipping on wet surfaces. d. Arrange frequently used items within reach: Rearrange kitchen utensils, pots, and pans to easily accessible heights, reducing the need for reaching or bending.

Strategies to improve safety in the bedroom

Reconfigure electrical outlets: Install additional electrical outlets in convenient locations to minimize the need for extension cords, which can be tripping hazards. Alternatively, consider using power strips with surge protectors to manage multiple devices. b. Organize cords: Secure cords against walls or use cord covers to prevent tripping accidents. c. Optimize furniture placement: Rearrange furniture to ensure clear pathways and eliminate obstacles that may impede safe movement within the bedroom. d. Install bedside lighting: Place a bedside lamp within reach to provide adequate lighting during nighttime activities, reducing the risk of falls or accidents.

Conclusion

Creating a safe living environment is crucial for an elderly stroke survivor to maintain independence and prevent accidents (Wing et al., 2017). By addressing the specific safety concerns identified during the assessment, such as clutter, throw rugs, scattered medication bottles, and the presence of pets, we can implement strategies to enhance ambulation safety, increase kitchen safety, and improve safety within the bedroom. These measures will empower the 86-year-old retired waitress to navigate her home with confidence and minimize the risk of injuries, promoting a higher quality of life during her recovery and beyond.

References

Lam, R. (2007, December 1). Choosing the correct walking aid for patients. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231545/ 

Radiation, Lab, and Drug Hazards. (2014). In Productivity Press eBooks (pp. 196–235). https://doi.org/10.1201/b17852-12 

Wing, J. J., Burke, J. F., Clarke, P., Feng, C., & Skolarus, L. E. (2017). The role of the environment in falls among stroke survivors. Archives of Gerontology and Geriatrics, 72, 1–5. https://doi.org/10.1016/j.archger.2017.04.007 

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