Hydration

Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most people can survive only three or four days without water. Water helps you to maintain body temperature, metabolize body fat, aids in digestion, lubricates and cushions organs, transports nutrients, and flushes toxins from your body.

Long-term care residents, especially residents with dysphasia who are orally fed, are at increased risk for dehydration.  Older residents are also at increased risk for dehydration because the mechanism that triggers thirst becomes less sensitive with age.  As we age, a lower percentage of our body weight is water, so dehydration occurs more rapidly.    Anyone may become dehydrated, but young children, older adults and people with chronic illnesses are most at risk. 

Residents who have the following are at risk for becoming dehydrated:

• Dementia/cognitive impairment
• Fever
• Diarrhea/vomiting
• Dependence on staff for eating and drinking
• Difficulty swallowing
• Use of certain medications
• Excessive sweating
• Draining wounds or pressure ulcers
• Depression

The following are signs and symptoms of dehydration:

• Rapid weight loss
• Dry or sunken eyes
• Dry mouth
• Changes in mental status
• Fever
• Vomiting
• Concentrated urine/decreased urine volume
• Dizziness
• Increased combativeness or confusion

Below are appropriate interventions to prevent dehydration:

• Offer fluids frequently throughout the day (at med passes, before and after personal care, at activities, before bedtime).
• Provide early morning beverage carts, provide mid-day hydration carts, or evening beverage carts.
• Offer extra fluids on meal trays
• Offer ice chips, ice cream, fruit ices, soups, gelatins, and other foods with a high fluid content.
• Monitor at-risk patients for physical signs of dehydration.
• Refer patient to speech and language pathologist if patient appears to have difficulty swallowing.
• Recommend adaptive equipment for eating and drinking if appropriate
• Report signs/symptoms of dehydration to nursing staff