Locating the Client’s Home “You can’t miss our place,” Diane had reassured me on the phone. I slowed in front of the decrepit Sunrise Motel, its roof partially collapsed, and reviewed my notes. I was...

Locating the Client’s Home

“You can’t miss our place,” Diane had reassured me on the phone. I slowed in front of the decrepit Sunrise Motel, its roof partially collapsed, and reviewed my notes. I was supposed to turn right on the unmarked gravel road just after the abandoned motel and continue until the road ended. I proceeded slowly through an evergreen tunnel past an old green truck body resting belly up. A little girl, perhaps 5 years old, came from around the truck and joined two grade-school-aged boys playing Frisbee in a clearing. I asked them where Diane Quimby lived, and they pointed around a curve in the road. In a moment, I came to a stop near a large wood and metal shed with smoke coming out of a crooked metal pipe in the roof. I knocked. No answer. I heard dialogue from “General Hospital” coming from inside. I knocked again and shouted, “Hello! It’s the nurse.” “Come on in!” a loud voice responded. I pushed open the door. There was no knob. Illuminated by one weak lamp, I could just make out a round face with wire rim glasses and a long gray-blond braid. Here was Diane, sitting on a sagging sofa facing a TV tray and watching a flickering black-and-white television. I could see a wooden table in a corner, three mismatched dinette chairs, and a couple of cots against the wall. The air was hazy with the smell of wood smoke. Diane invited me to pull up a chair. “We’re worried about your infections,” I began. Diane had unstable, insulin-dependent diabetes and high blood pressure. In June, surgeons had removed her gangrenous left foot with an amputation that ended just below the left knee. Now there was an infection in the wound that had not healed despite extended use of antibiotics. During the course of the visit, I learned that Diane had no tub or shower for bathing. She also had no money for dressings and no supplies. Since Diane’s vision was impaired, her 9-year-old grandson was doing the dressing changes. Until the latest surgery, Diane worked as a cook in a local “boarding home” for frail elders. She was 66 years old and had Medicare coverage. I learned that Diane was the legal guardian for two grandchildren, ages 5 and 9. Apply the nursing process to comprehensively identify and prioritize nursing diagnoses and propose interventions. Use the Home Health Nursing Caregiving Wheel to guide your care planning.