Good hydration is important for everyone, but for elderly people it can be particularly crucial. With Nutrition and Hydration Week taking place from 13th-19th March 2017, now is the perfect time to start thinking about what you can do to help keep residents hydrated.
What are the dangers of dehydration in the elderly?
Dehydration can have a big impact on a person’s overall health, particularly if that person is elderly or has other health conditions. Sadly, although dehydration is easily prevented, it is all too common amongst older people, and possible consequences can include:
- Increased feelings of tiredness
- Reduced mental capacity – including memory and concentration
- Low blood pressure
- Weakness or dizziness
- Increased risk of falls
- Increased risk of urinary tract infections (UTIs) and kidney problems
- Greater likelihood of problems in the event of a stroke
- Increased chances of developing pressure sores or other skin conditions
The importance of hydration in care homes
Preventable dehydration is an indicator of poor quality care, so it is very important to take steps to guard against it. In any care setting, staff should be trained on the risks of dehydration, as well as how to prevent it from developing.
The Care Quality Commission requires all health and social care facilities to ensure that residents’ hydration needs are met, in accordance with the Health and Social Care Act - Regulation 14. Care providers must ensure that individuals in their care have all the nutrition and hydration they need, as well as any further support required. The CQC can prosecute a care provider if they fail to meet these needs and it results in an individual being exposed to significant harm.
Risk factors for dehydration
Elderly people are more vulnerable to dehydration, and factors which may increase their risk of developing dehydration are as follows:
- Being unable to eat or drink without assistance - If an individual is in long-term care and needs help to eat and drink, they may be more at risk of developing dehydration. This could become more of a problem if there are not enough staff available to help.
- Incontinence – Individuals suffering from incontinence may drink less in an attempt to avoid needing to urinate. However, restricting fluids in this way does not reduce the severity of incontinence, and could cause the individual more health problems in the long run.
- Decreased cognitive function – If an individual is less mentally able (for instance if they have dementia), this could be a risk factor, as they may be less likely to remember to drink regularly.
- Kidney problems – If an individual has reduced kidney function, this may be a risk factor, as the body may not respond to dehydration properly.
- Depression – If an individual is struggling with depression, they may be less likely to take steps to care for themselves, including making sure that they eat and drink enough.
- Illness - If a person is suffering from an acute illness, this may cause them to become dehydrated, particularly if they experience vomiting or diarrhoea.
- Use of certain medications – Some medication could increase the risk of individuals becoming dehydrated – particularly diuretics and laxatives.
- Decreased thirst – Older people may not feel thirsty, even if they are in fact dehydrated. This can be more of a problem for individuals with Alzheimer’s disease and those who have suffered a stroke.
What are the symptoms of dehydration in the elderly?
Signs which could indicate dehydration in an elderly person include:
- Dry mouth
- Reduced output of urine
- Dark coloured urine
- Low blood pressure
- Rapid heart rate
- Sunken eyes
- Confusion or disorientation
- Difficulty walking
- Dry skin
- Inability to sweat or produce tears
How to prevent dehydration in the elderly
Improving hydration can help to improve an individual’s overall wellbeing and quality of life, so it’s important for care staff to do everything they can to keep residents topped up with fluids.
Possible ways to help prevent dehydration in your care home could include:
- Ensuring that staff are thoroughly trained on the importance of hydration, as well as risk factors and symptoms to look out for.
- Making drinks look more appealing – for instance, preparing water with ice and lemon.
- Offering a selection of drinks to suit all tastes – both hot and cold.
- Providing residents with their preferred drinks wherever possible.
- Ensuring that drinks are easy to access for those who are able to prepare them themselves.
- Making sure that staff are readily available for those who need more help.
- Setting a goal for each resident in terms of how much liquid they should be consuming each day – and measuring whether this is achieved.
- Offering drinks at regular intervals throughout the day.
- Offering a full glass of water with any medication which is provided.
- Ensuring that cups are easy to use, and providing individuals with specialist cups if needed – for example, here at Care Shop we offer a range of cups for people with dementia.
- Encouraging visitors to offer residents fluids.
- Providing residents with wet foods, such as jelly or soup.
- Providing and fitting specialist equipment when required to treat dehydration, such as an IV drip and cannula.
Staff should also seek to understand any factors which may be discouraging residents from drinking regularly, such as incontinence, and explain to residents why hydration is so important.
For more guidance, take a look at the British Nutrition Foundation’s healthy hydration guide.
What is Nutrition and Hydration Week?
Nutrition and Hydration Week was originally set up to highlight the importance of good nutrition and hydration in health and social care settings. It’s now become an event on a global scale, raising the issue of how important food and drink can be to the health and wellbeing of everyone.
Nutrition and Hydration Week 2017 is being held from 13th-19th March. A worldwide afternoon tea will be celebrated on Wednesday 15th March, with afternoon tea being served in health and social care settings around the world. The idea is that all care settings, whether large or small, can join in by serving up an afternoon tea to show their commitment to providing nutritional care.
Why not treat your residents to an afternoon tea at your care home? Take some photos, and be sure to tweet us here @CareShopBunzl, using the hashtag #NHW2017.