An unsatisfactory pattern of knowledge and activities for the safe upkeep of one's residence

• Competing demands
• Confusion
• Depressive symptoms
• Difficulty with decision-making
• Impaired physical mobility
• Impaired postural balance
• Inadequate knowledge of home maintenance
• Inadequate knowledge of social resources
• Inadequate organizational skills
• Inadequate physical endurance
• Inadequate role models
• Inadequate social support
• Powerlessness
• Psychological distress
• Unaddressed environmental constraints

• Mental disorders
• Neoplasms
• Sensation disorders
• Vascular diseases

• Age and gender of occupants at home
• Home environment
• Financial resources
• Patient's and family's knowledge of care requirements
• Patient's and family's psychological status, including perception of reality, communication patterns, assignment of responsibilities, degree of awareness and concern, and history of psychiatric illness
• Drug or alcohol abuse
• Support systems, including close friends, organizations with which patient is affiliated, and community resources

• Cluttered environment
• Difficulty maintaining a comfortable environment
• Failure to request assistance with home maintenance
• Home task-related anxiety
• Home task-related stress
• Impaired ability to regulate finances
• Negative affect toward home maintenance
• Neglected laundry
• Pattern of hygiene-related diseases
• Trash accumulation
• Unsafe cooking equipment
• Unsanitary environment

• Patient/family members will maintain a healthy home environment.
• Patient/family members develop a plan to correct health and safety hazards at home.
• Patient/family members will utilize community resources available to help maintain home.

Suggested NOC Outcomes

• Help patient/family identify strengths and weaknesses in current home maintenance practices to provide a focus for interventions.
• Discuss with patient/family obstacles to meeting home maintenance needs to provide the basis for a program to meet health and safety requirements.
• Determine patient/family ability and motivation to achieve a higher level of home maintenance. Self-motivation is necessary to ensure change.
• Discuss obstacles to effective home maintenance management with patient and family to develop understanding of potential and actual health and safety hazards.
• Help family members assign responsibilities for household care and establish appropriate expectations to aid communication and help set realistic goals.
• Help family members establish daily and weekly home maintenance activities and assignments to impose structure on family's routine and set standards for measuring progress.
• Conduct a home visit or evaluate patient's description of own home to assess safety needs and make recommendations for structural alterations. For example, the patient may benefit from installing ramps, enlarging doorways, or moving a second-floor bedroom to the first-floor family room.
• Based on assessment of patient's health and home environment, determine the need for assistive devices, including: Using assistive devices improves safe environment.
  • Telephones for hearing impaired
  • Telephone dial covers with large numbers
  • Telephones with programmed dialing
  • Amplifiers for phone receivers
  • Clocks that chime or recite time
  • Handrails
  • Safety bars for toilet and bath
  • Automatic chair lifts
  • Commode chairs
  • Shower chairs
• Discuss alternative housing opportunities with patient and caregiver, such as moving patient to a life-care community, to provide necessary information to make appropriate decisions regarding patient's future.
• Provide family with written information on medications and various aspects of patient's treatment. The more competent family members feel, the greater the possibility patient will progress without difficulty.
• Encourage weekly discussions about progress in maintaining home maintenance schedule to develop family unity and allow members to address problems before they become overwhelming.
• Assist patient and family members in exploring available resources to help with home and safety needs.
• Help family members contact community resources that can assist them in their efforts to improve home maintenance management, such as self-help groups, cleaning services, and exterminators. Community resources can lessen family's burden while members learn to function independently.

Suggested NIC Interventions

• Patient and family members establish and follow daily and weekly schedule for home maintenance.
• Patient and family members describe changes needed to promote maximum health and safety at home.
• Patient and family members list agencies that can assist with home care.
• Patient and family members contact community resources.
• Patient and family members identify individuals or organizations that may provide assistance.

• Patient's and family members' expressions of difficulty in maintaining household
• Patient's and family members' perception of problem
• Patient's and family members' mental status
• Presence of health hazards, such as filth, rodents, and waste matter
• Presence of safety hazards, such as faulty wiring
• Presence of offensive odors
• Patient's and family members' understanding of home maintenance management and resources
• Interventions to improve home maintenance skills
• Patient's and family members' responses to nursing interventions
• Evaluations for expected outcomes

• Gutman, S., Berg, J., Amarantos, K., Chen, E., Schlugar, Z., & Peters, R. (2017). Assessing home safety fall and accident risk in the prematurely aging, formerly homeless population. American Journal of Occupational Therapy, 71, 21. doi:10.5014/ajot.2017.71S1-PO6127
• Polletta, V. L., Reid, M., Barros, E., Duarte, C., Donaher, K., Wensley, H., & Wolff, L. (2017). Role of landlords in creating healthy homes: Section 8 landlord perspectives on healthy housing practices. American Journal of Health Promotion, 31(6), 511-514. doi:10.1177/0890117116671081
• Rostad, W., McFry, E., Self-Brown, S., Damashek, A., & Whitaker, D. (2017). Reducing safety hazards in the home through the use of an evidence-based parenting program. Journal of Child and Family Studies, 26(9), 2602-2609. doi:10.1007/s10826-017-0756-y
• Woodruff, R. C., Haardörfer, R., Kegler, M. C., Gazmararian, J. A., Ballard, D., Addison, A. R., … Tucker, R. B. (2019). Home environment-focused intervention improves dietary quality: A secondary analysis from the healthy homes/healthy families randomized trial. Journal of Nutrition Education and Behavior, 51(1), 96-100. doi:10.1016/j.jneb.2018.06.007