PURPOSE: In the present study, we investigated the effect of the family-centered empowerment model (FCEM) in the home care of older adult patients after total knee arthroplasty (TKA). DESIGN: The current study was a randomized controlled study. METHODS: Two hundred eighty older adult patients who underwent TKA in our hospital from December 2020 to December 2022 were selected. They were divided into intervention and control groups using the random number table method, with 140 cases in each group. After follow-up and attrition, 133 patients were assigned to the intervention group and 130 to the control group. The control group received conventional care, and the intervention group received the care provided using the FCEM. The general characteristics of the study subjects were compiled using a general information questionnaire designed by the researcher. The chi-square test and t-test were used to compare the changes in self-care efficacy, knee function, and the occurrence of postoperative complications in the two groups before and after the intervention. FINDINGS: The results suggest that the adoption of FCEM improved patient motivation and self-care efficacy, promoted the recovery of knee function in the short term after surgery, and reduced the likelihood of occurrence of complications. CONCLUSION: The present study highlights the importance of extending the FCEM to multiple domains to fill the gaps in the currently available medical care system for older adults. In addition, the study provides a reference basis for reducing the occurrence of complications and improving patient prognosis. CLINICAL EVIDENCE: The FCEM model is an effective strategy to improve the effectiveness of home nursing for older adults.