This article describes the nursing experience in management of medication and home environment safety for a community elderly by applying the Omaha system from June 23rd to August 5th of 2009, the author developed mutual trust relationship with elderly and family by regular home visiting and telephone interviews. The comprehensive health assessment was based on the Omaha system. The assessment result showed that the nursing health problems included 'Safety: Risk for Falls', 'Medicine Effect and Side Effect：Risk for Injury', 'Nutrition Imbalanced: More Than Body Requirements', and 'Medicine Consultation and Management Development: Lack Effective Communication'. Nursing interventions included 'to educate patient knowledge about environment safety and fall prevention', 'to enhance self awareness about medication side effect', 'to provide information regarding diet and nutrition intake', and 'to advocate strategies about medication management'. The first priority for this patient would be the safety medication used. The author provided nursing interventions to enhance knowledge of health promotion in order to promote safety environment and medication used and improve the quality of life. Hopefully, this article can provide information concerning assessment and promote safety home environment and medication used for other nursing staff.