Patients in the acute care setting may be discharged to an extended care facility. Patients requiring relatively short-term
rehabilitation and those needing long-term care/permanent nursing care are included in this group. The level of care and
needs of the patient (e.g., physical, occupational, rehabilitation therapy; IV and respiratory support) are frequently the
deciding factors in the choice of placement. Although elderly people are the primary population in extended care
facilities, increasing numbers of younger individuals are requiring care for debilitating conditions when they cannot be
managed in the home setting.
Acquired immunodeficiency syndrome (AIDS)
Psychosocial aspects of care
Spinal cord injury
Ventilatory assistance (mechanical)
Patient Assessment Database
Data depend on underlying physical/psychosocial conditions necessitating continuation of structured care.
Projected mean length of stay: Depends on underlying disease/condition and
individual care needs. Therefore, this may be
temporary or permanent placement.
May require assistance with treatments, self-care activities, homemaker/maintenance tasks,
or alternate living arrangements (e.g., group home)
Refer to section at end of plan for postdischarge considerations.
DIAGNOSTIC STUDIES (dependent on age, general health,
and medical condition)
Reveals problems such as infection, anemia, other abnormalities.
Evaluates general organ function/imbalances. Age-related changes include decreased serum
albumin, up to 20% increase in alkaline phosphatase, decreased urine creatinine clearance.
Provides information about kidney function; determines presence of urinary tract infection (UTI) or DM.
Bacteria is common in some populations, especially the elderly and bed-ridden, reflecting urinary stasis.
Determines oxygenation, respiratory function.
Communicable disease screens:
To rule out tuberculosis (TB), HIV, venereal disease, hepatitis.
As indicated by usage to identify therapeutic or toxic levels.
Visual acuity testing:
Identifies cataracts/other vision problems.
Measures intraocular pressure.
Reveals size of heart, lung abnormalities/disease conditions, changes of the large blood vessels and bony
structure of the chest.
Provides baseline data; detects abnormalities, e.g., ST segment and T wave changes, atrial and ventricular
dysrhythmias, and various heart blocks are common in the elderly.
1. Promote physiological and psychological well-being.