Elder Dehydration Abuse

Updated 7/21/2017

There’s a lot more to being dehydrated than just being thirsty, but for most people being thirsty isn’t a good thing. It usually means that they are already at least mildly dehydrated. Dehydration is a medical condition that can and does, happen to nursing home residents. The prevalence of inadequate hydration is estimated to be close to 100%, meaning that nearly 100% of nursing home residents do not receive adequate hydration during some point in their time spent at the nursing home. Adequate hydration, through water or other fluid and adequate intake of food, is a basic need. It is important that nursing home residents intake more than 1.5 liters of fluids each day, with a significant portion of fluids consumed being hydrating beverages, rather than dehydrating beverages, such as coffee or tea.

When dehydration does occur, it can have serious, even fatal consequences. State and federal regulations require nursing homes to ensure that their residents maintain adequate hydration. As such, when a nursing home resident becomes dehydrated, it should not be tolerated. It is also possible that the nursing home may be guilty of negligence, and it is worth investigating.

Dehydration Classified

Dehydration exists in various degrees, or classifications of dehydration, as defined by researchers at Texas A&M University: mild, moderate and severe. Less than a five percent loss of body weight is classified as mild dehydration, between five percent and ten percent loss of body weight is classified as moderate dehydration and between ten to fifteen percent loss of body weight is considered severe dehydration. Water is very effective at combating the effects of dehydration. Older adults should consume plenty of water each day.

Keeping Nursing Home Residents Hydrated

In order to stay properly hydrated, a person should usually consume just over six cups of liquids each day, and the majority of that liquid should be a hydrating beverage, such as water, milk, or herbal teas rather than non-hydrating beverages, like coffee or tea. If a person is thirsty, it means that it is time to have something to drink — preferably water or other hydrating beverage.

Mild dehydration can easily happen to almost anyone who has gone more than a few hours without water. Early signs that this might be a problem include:

  • Darkening of urine
  • Decreased energy
  • A drop in mood
  • Headaches
  • Problems concentrating

While these symptoms can appear in anyone, it is more likely that they will be noticeable in women. When they do occur, they need to be addressed right away before mild dehydration becomes severe hydration, which can have much more serious consequences.

Dehydration Causes Electrolyte Imbalance

Electrolytes are minerals in the blood that need to be maintained in a particular balance with water in order to properly support homeostatic conditions in the body. These elements are particularly vital in the process of transmitting electrical impulses amongst the body’s cells. When dehydration occurs, the ratio of electrolytes to water is disrupted, causing an electrolyte imbalance. The most disruptive electrolyte imbalances that result from dehydration affect sodium concentrations, potassium levels, and the amount of chloride that is available in the blood.

Severe Hydration and the Brain

Cerebral Edema

One of the biggest reasons why it is so important to pay attention to hydration is because brain cells can actually swell and burst, a condition called cerebral edema. An electrolyte imbalance, particularly involving sodium levels, can trigger cerebral edema. Dehydration that is due to vomiting or profuse sweating can cause a loss of sodium in bodily fluids. Salt is important to maintaining the appropriate amount of fluid within individual cells. When too much salt is lost, the body works to produce replacement particles that draw fluid into the cells, which can cause cells to swell to the point of bursting. Brain cells that swell and burst cause cerebral edema, which is a dangerous medical condition. While the brain can adjust to small increases in fluid volume inside cells over time, a dramatic or incredibly rapid increase is intolerable as an excess of fluid buildups in the brain. This buildup compromises brain functionality and can even possibly be fatal. Edema happens when cells soak up too much liquid and rupture. This can happen in areas other than in the brain, and can damage other cells too, but the rupturing of brain cells bring special concern.

If a person is experiencing cerebral edema, or is on the verge of developing the condition, it is important that it is treated very carefully. If liquids are added too quickly, it can actually cause further swelling of brain cells and increase the chance that those cells will burst. It can also cause damage to blood vessels. Any number of these injuries can further cause blood clots to form in the brain, which can cause a stroke in the affected individual.

Heat Injuries

Even if dehydration doesn’t lead to cerebral edema, heat injuries can still be damaging and uncomfortable. If nursing home residents are put in a position where they exercise and perspire they will need to have an increased amount of fluids in order to stay hydrated. Heat exhaustion can lead to cramping, and if the situation is allowed to continue, heatstroke may occur, which can also be potentially life-threatening. Nursing home facilities need to make sure their facilities are kept at a comfortable temperature and restrict outdoor activities during excessive heat in order to prevent these injuries from happening.


In some cases being dehydrated can include the symptom of an electrolyte imbalance. Potassium and sodium are both electrolytes that send electrical messages from the brain. An imbalance can act like a short circuit and lead to involuntary muscle contractions, or seizures. In some cases, these can even lead to a person becoming unconscious.

Hypovolemic Shock

Hypovolemic shock is also known as low blood volume shock, and it is often a life-threatening complication of dehydration. A person’s blood pressure experiences a drop, as does the amount of oxygen in the body. This can lead to kidney failure. If this is not properly treated, the kidneys will not do their job clearing out excess fluids and waste from the body, potentially triggering a coma and/or death.

Contact a Dehydration Attorney

If your loved one is not getting the quality care they need and deserve in a nursing home, it is important to step in and take a stand as soon as possible. Taking legal action can lead to an improvement in care, and may force the nursing home to address care issues not only for your family member, but for other residents of the home as well. The Rooth Law Firm has helped many nursing home residents and their families fight negligence and abuse. Contact us online or by phone at (847) 869-9100 to learn more about what we can do for your family.

Photo Credit: peasap via Compfight cc


Royal College of Nursing, Water for Health, Hydration Best Practice Toolkit for Hospitals and Healthcare