DISCHARGE PLANNING AND HOME FOLLOW-UP OF THE ELDERLY PATIENT WITH HEART-FAILURE

Older adults with heart failure have extensive and complex care needs. This article presents a framework for assessment and intervention wit h this fragile patient group. Comprehensive assessment of elders with heart failure includes gathering information about care, advocacy, and knowledge needs. Nursing interventions are focused on providing direc t care, counseling, teaching, and advocacy. The unique role of the adv anced practice nurse in discharge planning and home follow-up of elder s with heart failure is emphasized.