An emergency nurse is preparing to discharge a 72-year-old patient with a history of dementia who was treated for a fall resulting in a hip contusion. The patient lives alone and has limited social support. Which of the following discharge planning strategies is MOST appropriate for this patient?
Provide detailed written discharge instructions in large print
Consult a social worker to assess the need for additional services
Contact family members to inform them of the discharge plan
Arrange for a home health nurse evaluation within 24 hours of discharge
The correct answer is to arrange for a home health nurse evaluation within 24 hours of discharge. This strategy addresses the complex needs of an elderly patient with cognitive impairment and limited support who has experienced a fall. A home health nurse can assess the patient's home environment, evaluate their ability to follow discharge instructions, ensure proper medication management, and identify any additional support needs or safety concerns. This approach is more comprehensive than simply providing written instructions or contacting family members, which may not be sufficient given the patient's cognitive status and lack of support. While involving a social worker is beneficial, it doesn't provide the immediate, hands-on assessment that a home health nurse can offer. Arranging for home health services demonstrates a proactive approach to preventing complications, reducing the risk of readmission, and ensuring continuity of care for a vulnerable patient. It also aligns with best practices in geriatric emergency medicine and discharge planning for high-risk patients.
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