Nursing Home Dehydration

Muscle serves as the body’s primary reservoir of water, making up about 60% of the adult human body. However, as people age, their muscle mass decreases, bringing this percentage down to only about 50%. Dehydration is common in older adults and is linked to several serious adverse events, including longer hospital stays and higher mortality rates.

What is dehydration and when does it occur? 

Dehydration can occur when there is an insufficient intake of fluid in the body or an excessive loss of fluids from the body causing disruption in the body’s ability to function. It is a condition in which elderly residents have insufficient fluid in their bodies, resulting in a negative fluid balance. Elderly patients are more likely to experience dehydration for several natural reasons. Sadly, the likelihood is worsened for nursing home residents who may have experienced abuse and neglect.

Dehydration can be mild, moderate, or severe and while people who suffer mild dehydration may recover quickly by increasing their fluid intake, it is difficult for elderly residents who are under the care and supervision of the nursing home staff to recover from dehydration. This might lead to significant complications of dehydration in its more advanced stages of dehydration which may result in: 

  1. Increased vulnerability to infections: Dehydration weakens the immune system, making residents more susceptible to infections such as urinary tract infections, respiratory infections, and skin infections.
  2. Worsening of chronic medical conditions: Dehydration can exacerbate pre-existing chronic conditions like hypertension, diabetes, and kidney disease, leading to poor disease management and potential complications.
  3. Cognitive decline and confusion: Elderly residents experiencing dehydration may suffer from cognitive impairment, including confusion, disorientation, and difficulties with memory and decision-making.
  4. Increased risk of falls and injuries: Dehydration can cause weakness, dizziness, and lightheadedness, increasing the likelihood of falls and related injuries among nursing home residents.
  5. Adverse effects on skin integrity: Inadequate hydration can lead to dry and cracked skin, making residents more prone to pressure ulcers and skin breakdown.
  6. Impact on psychological well-being: Dehydration can contribute to feelings of discomfort, irritability, and overall decline in psychological well-being, potentially leading to social withdrawal and decreased engagement in activities.
  7. Increased mortality risk: Severe dehydration, if left untreated, can lead to life-threatening complications, and increase the risk of mortality among nursing home residents.

What are the risk factors for dehydration?

For older nursing home residents, dehydration is a serious health concern, and it can be caused by several risk factors. The following are some of the main risk factors for dehydration in old nursing home patients:

  1. Age: As people age, their bodies lose water at a faster rate. Older adults also may not feel thirsty as often, which can lead to dehydration.
  2. Chronic medical conditions: Chronic medical conditions, such as diabetes or kidney disease, can increase the risk of dehydration.
  3. Medications: Some medications, such as diuretics or laxatives, can cause dehydration by increasing urine output or promoting fluid loss through bowel movements.
  4. Mobility limitations: Elderly nursing home residents who have limited mobility may not be able to get to water sources as easily, or they may not be able to communicate their thirst.
  5. Cognitive impairment: Elderly nursing home residents who have cognitive impairment may not remember to drink enough water or may not recognize the signs of dehydration.
  6. Poor fluid intake: Elderly nursing home residents may not drink enough water or other fluids due to a lack of access to water or difficulty swallowing.
  7. Hot weather: Hot weather can increase the risk of dehydration, especially for elderly nursing home residents who have limited access to air conditioning or may not be able to cool themselves down.

What are the signs of Dehydration in Nursing Home Residents? 

Elderly nursing home residents may have decreased thirst sensation or cognitive impairment, making it more challenging for them to recognize when they need to drink more fluids.  If dehydration symptoms are not detected at a nursing home serious complications can occur. Early indications of dehydration can be difficult to detect, so it’s critical to pay close attention to some of the common signs of dehydration that nursing homes sometimes might overlook.  These include the following:

  • Dry Skin 
  • Constipation 
  • Weight loss 
  • Fainting 
  • Hallucinating 
  • Muscle twitching 
  • Slurred Speech 
  • Swollen Feet 
  • Low blood pressure (with high heart rate)
  • Loss of appetite
  • Flushed skin 
  • Dry mouth or dry cough 
  • Decreased urine output 
  • Irritability 
  • Quick breathing 

If you’re concerned about a loved one’s hydration status, speak to their healthcare provider or the nursing home staff. Severe dehydration complications might result in life-threatening situations and even death.

What are the care plan interventions to protect against dehydration in elderly nursing home residents?

Care plan interventions to protect against dehydration in elderly nursing home residents may include:

  1. Encouraging fluid intake: Encourage elderly nursing home residents to drink water or other fluids regularly. Offer water and other beverages frequently throughout the day and ensure that residents have easy access to water sources.
  2. Providing fluids with meals: Serve water or other fluids with meals to help residents stay hydrated. Offering soups or juices that are high in water content can also be beneficial.
  3. Monitoring fluid intake: Keep track of how much fluid elderly nursing home residents are consuming to ensure that they are meeting their hydration needs.
  4. Offering hydration assistance: Offer assistance to elderly nursing home residents who have difficulty drinking from cups or bottles, such as providing straws or cups with built-in straws.
  5. Using hydration reminders: Use hydration reminders, such as signs or alarms, to remind elderly nursing home residents to drink fluids regularly.
  6. Monitoring urine output: Monitor the frequency and color of elderly nursing home residents’ urine output to assess their hydration status. Dark urine can indicate dehydration.
  7. Providing water-rich foods: Offer foods with a high-water content, such as watermelon or cucumber, to help elderly nursing home residents stay hydrated.
  8. Monitoring medication side effects: Monitor elderly nursing home residents who are taking medications that can cause dehydration and adjust their fluid intake as necessary.
  9. Providing air conditioning: Ensure that the nursing home is properly air-conditioned to help elderly nursing home residents stay cool and hydrated during hot weather.

Overall, preventing dehydration in elderly nursing home residents requires a multifaceted approach that addresses fluid intake, mobility, and cognitive impairments. Recognizing the signs of dehydration, raising awareness among staff and residents, and promoting a supportive environment that encourages adequate fluid intake are essential. Care plan interventions should be tailored to the individual needs of each resident and regularly reviewed to ensure their effectiveness. Through these efforts, nursing homes can help safeguard the hydration status of elderly residents, reducing the likelihood of complications associated with dehydration and promoting their overall quality of life.

Take Legal Action for Dehydration in Nursing homes!

If a family member or friend has experienced complications due to dehydration in a nursing home setting, call the experienced Illinois attorneys at The Rooth Law Firm for a free consultation to discuss your case and explore legal options available. Together we can seek justice and improve the standard of care for elderly nursing home residents.