Successful nursing strategies that address the home care needs of the dependent elderly and their care givers require an expanded knowledge base for the community health nurse. Needs of the care-giving dyad are analyzed through a case study, discussion of the concept of respite, application of the nursing process, and an assessment tool. The assessment tool reflects the clinical experiences of the nursing staff in a medium-size (35,000 visits annually), Midwestern, home health agency. Meeting the needs of care givers is the shared responsibility of the community health nurse and the home health agency, whose tasks include educating staff to the care givers' needs and assuming an advocacy role for both the dependent elderly and their families. Accurate needs assessment of the client and his or her family may prevent family burnout, extend care-giving abilities, conserve family resources, and delay or prevent institutionalization.
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