Dehydration is a serious problem in nursing homes. According to a study by the London School of Hygiene and Tropical Medicine, elderly nursing home patients are more likely to be dehydrated than elderly people in other living situations. (Reuters, Nursing home patients more likely to be dehydrated.)
It’s important to understand the causes and symptoms of dehydration in nursing home patients because it may point to the care facility’s staff being negligent.
Causes of Dehydration in Nursing Home Patients
Many factors contribute to dehydration in a nursing home setting, including:
- For older adults, the instinct to recognize and respond to thirst naturally decreases. A resident may not be able to readily identify when they are thirsty and need a drink
- Kidney disease may prevent the body from regulating fluids
- Certain medicines can remove water from the body
- Rapidly-changing conditions (dehydration can happen quickly), so staff does not realize that there is a problem
- The body is less able at an older age to hold a reserve of fluid to respond to thirst
- Difficulty drinking at mealtime and a lack of personnel to assist with proper drinking positions
- Cognitive functional impairment, where the person cannot ask for a drink or self-help
- Too few opportunities to drink between meals
- Sociocultural factors including preference of beverage or an inability to express the need for fluids
- Inadequate staff
- Staff that is not skilled in recognizing symptoms of dehydration
Most often, multiple factors contribute to dehydration in a nursing home patient. These factors combine to make dehydration a common problem for nursing home residents.
Sources: J Kayser-Jones 1 , E S Schell, C Porter, J C Barbaccia, H Shaw, Journal of the American Geriatric Society: Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision, 1999.
National Kidney Foundation, Can Dehydration Affect Your Kidneys
Symptoms of Dehydration in Nursing Home Patients
Because dehydration can be a common problem among nursing home patients, it’s important to know the symptoms of dehydration:
- Headache: Dehydration usually causes a dull ache. The pain may be mild or severe.
- Weight loss or difficulty losing weight: Because of the weight of fluid, not drinking water can cause weight loss in the short term. However, dehydration may also make it difficult to lose weight in the longer term.
- Dizziness: This can also be accompanied by confusion and light-headedness.
- Muscle cramping: Muscles need fluid to operate correctly. Inadequate liquid consumption can interfere with normal muscle function.
- Urine and bowel movement changes: Dehydrated patients expel less urine, have a dark-yellow color instead of mostly clear urine, and may be constipated.
- Heat stroke: Heat stroke includes a severe and high spike in body temperature, rapid pulse, and fainting.
- Heat exhaustion: This may include weakness, excessive sweating, and nausea.
- Low blood pressure: A high heart rate despite low blood pressure may signal dehydration.
- Dry mouth: Bad breath can also accompany this symptom.
- Moodiness: This includes irritation and the inability to concentrate.
A person may not immediately recognize the signs as dehydration. They may wonder why they are feeling off. Dehydration may be the underlying cause of one or more symptoms.
Sources: Saskatchewan Health Foundation, Chronic Kidney Disease (CKD) and Dehydration and Fluid Overload
Cleveland Clinic, Dehydration
Methodist Health System, Are You Dehydrated?
What do you do if an elderly person is dehydrated?
If an elderly person is dehydrated, they should consume fluids as soon as possible. They may drink water or another beverage. They may also consume foods that are rich in water, like fruit. If necessary, severe hydration may be treated intravenously.
Mayo Clinic, Dehydration
How do you help a nursing home patient stay hydrated?
To help a nursing home patient stay hydrated, be sure they are offered drinks at regular intervals, including in between meals. They should be offered smaller amounts of fluid more frequently rather than a large amount at once. The patient should be correctly positioned to drink easily and safely. Sociocultural factors should be addressed so the patient can ask for a drink when they want one and have a drink they prefer.
Is dehydration neglect in a nursing home?
Dehydration in a nursing home may be a result of neglect. Proper care in a nursing home should address the person’s entire range of health needs. All the relevant factors for the person’s health should be addressed, including sufficient fluid intake.