Nursing Care of Dementia Patients with Bedridden in the Community : Case Study

Abstract

Abstract

            Introduction : Dementia is a condition characterized by a decline in brain function, leading to cognitive impairment that affects daily living and social interaction. Ultimately, elderly individuals with dementia become dependent on others for care.

            Objective : This study aimed to explore the nursing care of dementia patients with bedridden in the community.

            Methodology : A case study was conducted on one bedridden dementia patient under the care of Chalermprakiet Hospital,Nakhon Ratchasima province. between December 23, 2024, and May 31, 2025. Data were collected through medical records, patient and family interviews based on Gordon’s Functional Health Patterns, and assessment of activities of daily living. The nursing process was applied to assess needs, plan and implement care, and evaluate outcomes before, during, and after home visits to address the patient’s problems and needs.

            Results : The patient was an 88-year-old Thai female diagnosed with severe dementia, with comorbid conditions including hypertension, chronic kidney disease, and osteoarthritis of the knee. Six home visits were conducted. Assessments revealed nursing problems including cognitive and perceptual impairment, decreased ability to perform daily activities, pressure ulcers, risk of aspiration pneumonia, risk of falls due to lower limb weakness, and family stress and anxiety due to lack of knowledge in managing dementia-related behavioral and emotional issues. Despite the nursing interventions, continuous care is still required due to the complexity of the patient's condition. The combination of dementia and multiple health issues contributes to disability and full dependency, necessitating comprehensive and ongoing support in all aspects of care. Therefore, it is essential to develop a comprehensive healthcare service system and enhance the competencies of healthcare personnel to identify individuals at risk of dementia and initiate early care planning, which can lead to improved long-term outcomes for elderly patients.

Keywords : Nursing care, dementia patients, bedridden