Have you ever stopped to think about how often dehydration can sneak up on a resident when you least expect it? Dehydration in senior living communities is not just a summertime issue. It can happen any time of year. Older adults have a higher risk of low-intake dehydration due to physiological changes associated with aging, along with a decreased sense of thirst. The prevalence of low-intake dehydration in nursing homes ranges from 0.8% to 38.5% depending on the biochemical markers used to assess it. However, based on blood tests, the prevalence is about 26%. Even with how often it occurs and the outcomes tied to it, dehydration continues to be a problem in nursing homes.
In a study conducted in Spain, clinicians and managers identified several barriers to providing care for dehydration among residents. These included limited training, the absence of specific protocols, and imprecise record systems. Participants in the study noted that dehydration prevention was crucial because of its impact on the mental and physical health of residents.
Annual assessments are the norm and often include lab work, BMPs, and other routine testing. However, these tests do not measure serum osmolarity, which is the gold standard in diagnosing low-intake dehydration. We have all had that resident who goes to the ER and comes back with a dehydration diagnosis. Maybe that is because they are testing serum osmolarity, which we generally do not. This test provides a more accurate picture of hydration status and leads to a more conclusive diagnosis.
At the end of the day, be aware. Dehydration is not just a summer thing. It can happen all year long. Be proactive. Set up hydration stations. Serve plenty of fresh fruits and vegetables with meals. Pass ice water on every shift and as needed. Also, do not forget foods that count as “solid liquids” like watermelon, popsicles, and gelatin.
Remember, residents may refuse liquids because they fear incontinence. Support them, encourage them, and offer options that help meet their needs. Most importantly, make sure your staff are trained on what to watch for and when to send up the flag. Stop and Watch is a great tool for this, and there are others as well. Consider implementing the reporting system that works best for your community.
Be sure to review HealthCap’s hydration resources below to support prevention, monitoring, and staff awareness:
- Winter Hydration Clinical Essentials
- Dehydration in the Elderly
- Nutrition and Hydration Care Plan Isolation
- Winter Hydration for Clinical Staff
- Hydration Toolkit
Dehydration in senior living communities calls for awareness, consistency, and action. Put systems in place, support your staff, and stay proactive.
Stay well and stay informed!
