As life expectancy has increased all over the world, the burden of health related issues with growing age is now a day’s great challenge for the families. With advance age health problems are more visible like cardiac problem, behavioral changes like anger, agitation and neurological in competencies as dementia are very commonly seen which prone families to hire private nurses for long term care of elderly. Private nursing care is cheaper than hospital care and also easily accessible. But due to lack of adequate professional training, most of private nurses are unable understand the basic needs of elderly. Furthermore, lack of supervision from agencies providing private nurses are major contributors of below standard nursing care provision. As result, lack adequate formal and professional schooling system for private care nurses prone elderly to behavioral changes including agitation, irritability and unusual anger. Background: Health systems are undergoing rapid change and the requirements for conforming to the new challenges of changing demographics, disease patterns, emerging and reemerging diseases coupled with rising costs of health care delivery have forced (2) individual and families to find out different options to overcome the burden of health care related challenges. For long term care need, one option is to opt for home health nursing care which is cheaper as compared to hospitals. For example, it would be quite expensive to keep quadriplegic (all limbs paralysis) patient in hospital for rehabilitation care or an elderly patient who don’t have any family member at home to look after care needs. As longitivity have been increased one can predict the burden of care needs to elderly at homes. World Bank (2016) reported that Pakistan is the sixth most populated country with a population exceeding 212,742,631 in south Asia where the life expectancy has increased up to 66.48 year with compared to India (68.56 years) and Bangladesh (72.49 years).
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