Nursing intervention in primary care to improve treatment self-management in an older adult with cognitive impairment and frailty risk: a case report

Abstract

Introduction: Population ageing is associated with an increased risk of frailty among community-dwelling older adults, particularly in the presence of cognitive impairment and polypharmacy. Difficulties in treatment self-management represent a key factor in the development of clinical decompensations and preventable adverse events, highlighting the strategic role of primary care nurses.

Objective: To describe a primary care nursing approach for an older adult with cognitive impairment and frailty risk, focused on improving treatment self-management and preserving functional autonomy.

Case description: An 80-year-old man with multimorbidity, polypharmacy and moderate cognitive impairment, living alone, presented with recurrent clinical decompensations related to inadequate treatment adherence. Nursing assessment identified limitations in instrumental activities of daily living, insufficiently structured social support and frailty risk.
Nursing Intervention: A progressive and individualized care plan based on Comprehensive Geriatric Assessment was implemented, combining tailored therapeutic education, shared decision-making support, home supervision and the use of digital tools as a complement to human support.

Results: Sustained improvement in clinical control was observed, with reduced medication omissions and increased acceptance of external support, while maintaining functional independence and remaining at home.

Conclusions: A comprehensive, person-centred nursing intervention improved treatment management and reduced the risk of adverse events in an older adult with cognitive impairment and frailty risk, reinforcing the key role of primary care nurses in frailty prevention and autonomy preservation.