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Dehydration

Dehydration in the Nursing Home

Quick Answer

Dehydration in the nursing home is defined as having too little water in the body that causes a disruption in the body’s ability to function. Due to a variety of natural reasons, elderly patients are more likely to suffer from dehydration. This increased likelihood is sadly intensified in nursing home residents who may be victims of abuse and neglect.

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What Is Dehydration in Nursing Homes?

Dehydration occurs when the nursing home resident lost more fluid than they took in. The body is always losing water through urine, stool, breathing, and sweat. If these fluids aren’t replaced, the body will eventually not contain enough water to perform vital bodily functions.

When the elderly nursing home resident becomes dehydrated, they’re more likely to have a certain symptoms and health complications from not having enough fluid. Some elderly people won’t have a strong thirst or display symptoms.

These people need to be encouraged to drink water and other fluids even if they are not thirsty. Chronic dehydration in the elderly person is a common problem of many elderly people in nursing homes across America.

Understanding Nursing Home Dehydration

Dehydration in the nursing home resident is possibly the most common type of elder abuse and neglect among those living in nursing facilities.

In one study, the liquid intake of 40 nursing facility residents was monitored to see how much they drank. Nearly all of the residents suffered from inadequate hydration.

Even worse, 25 of the 40 participants suffered from diseases that may have been caused or exacerbated by their being dehydrated.

Causes of Dehydration in the Elderly

Studies conducted by the American Geriatric Society show that understaffing and lack of supervision are the primary causes of nursing home dehydration. As people age, their bodies become less able to hold a reserve of water and detect thirst.

One of the issues identified is the inability of the nursing facility resident to tell anyone that they are thirsty and need to take in fluids. Illnesses such as Alzheimer’s disease and other dementias create an even bigger challenge.

Other causes of nursing home dehydration include:

  • Colds or sore throats that make residents less likely to drink
  • Diarrhea and vomiting due to common illnesses
  • Excessive sweating due to certain cancer medications
  • Increased urination due to diuretics

Additionally, the elderly population, in general, has more problems with mobility, making getting up to get a drink a problem.

Although some risks for dehydration in nursing homes are difficult to stay ahead of, the condition is preventable. If the potential for dehydration is recognized early on, medical complications can usually be avoided through intervention.

Signs of Dehydration in Nursing Homes

Early symptoms of dehydration can be difficult to notice, so it’s especially important to pay close attention to some of the common signs of dehydration that nursing homes often overlook.

Often overlooked signs of nursing home dehydration include:

  • Confusion
  • Dark-colored urine
  • Difficulty walking
  • Hypotension (low blood pressure)
  • Muscle cramps
  • Rapid heart rate

According to the Mayo Clinic, mild to moderate dehydration can usually be reversed by drinking fluids. However, late-stage dehydration requires immediate medical care.

Therefore, it’s very important to be able to recognize the signs of dehydration in nursing homes. If nursing home dehydration symptoms are not caught and result in serious complications, it is likely to be considered nursing home neglect under both federal and state laws.

Early Stages of Dehydration Symptoms

  • Constipation
  • Dry mouth or dry cough
  • Flushed skin
  • Headache
  • Loss of appetite with a possible craving for sugar
  • Low blood pressure (with high heart rate)
  • Swollen feet

Late Stages of Dehydration Symptoms

  • Confusion or slurred speech
  • Fainting
  • Hallucinating
  • Lack of sweating
  • Muscle twitching
  • Seizures
  • Temperature above 102 degrees

If you believe your loved one is suffering from nursing home dehydration, it is urgent to seek medical help. They may need intravenous fluid or other emergency care. Complications from severe dehydration can cause life-threatening conditions and even death.

Complications from Dehydration in the Elderly

Dehydration can cause a number of other serious complications, so it is vital that nursing home staff monitor and address symptoms of dehydration promptly.

In nursing homes, being dehydrated often goes along with being malnourished. In fact, the combination of being dehydrated and malnourished led to the death of about 1,400 nursing facility residents between 1999 and 2002.

The complications of being dehydrated in the elderly population can lead to very serious illnesses, especially when the dehydration is a frequent or chronic condition.

Complications from nursing home dehydration include:

  • Coma: If the dehydration is very severe, the person may suffer from irretrievable health complications leading to unconsciousness and death.
  • Kidney stones, kidney disease, or kidney failure: When an elderly person is dehydrated, this can keep the kidneys from getting rid of waste in the bloodstream and the person will suffer from kidney failure.
  • Seizures: An elder who is dehydrated may experience a loss of consciousness and tonic clonic seizures due to imbalanced electrolytes
  • Swelling of the brain: If the individual drinks too much fluid after being dehydrated, their brain cells may try to store the fluid too quickly. This can cause rupture of the brain cells and brain damage.
  • Urinary tract infections

One of the more serious complications that can be caused by nursing home dehydration is hypovolemic shock, which occurs when blood pressure and the amount of oxygen in the body drop. Hypovolemia can be life-threatening and may even lead to death.

Unfortunately, employees may not be properly trained to recognize the symptoms of dehydration in nursing homes.

Preventing Nursing Home Dehydration

It is very important for family members and loved ones to understand the seriousness of dehydration in nursing homes so they can be on the lookout for red flags.

Some ways to help protect loved ones from dehydration include:

  • Asking nursing home staff to encourage your loved one to drink liquids even if they don’t feel thirsty
  • Bringing sports drinks, oral rehydration solutions, and other fluid replacement options when you visit
  • Ensuring urine output is being monitored
  • Requesting extra fluids for your loved one
  • Talking to your loved one’s health care providers about their risk of dehydration so you know how much water intake they need
  • Visiting at different times of the day to make sure water is available
Did You Know

A quick check for possible nursing home dehydration is pulling up the skin on the back of your loved one’s hand. If the skin does not return back to normal right away, it could be a sign of dehydration.

Dehydration and Nursing Home Neglect

Although family and friends can play a key role in preventing nursing home dehydration, the bottom line is that nursing homes have an obligation to prevent dehydration. Failure to do so is a form of abuse or neglect.

The 1987 Nursing Home Reform Act declared that not assisting residents in getting adequate hydration is a form of neglect.

In a study published by the National Institutes for Health (NIH), several factors contributed to dehydration in nursing homes. For example, the study found that fluid intake in residents was inconsistent, and even when fluids were given regularly, oftentimes it was not enough water.

“Using three established standards, we found that the fluid intake was inadequate for nearly all of the residents.”

Journal of American Geriatric Society

The study also found that some residents were unable to communicate their thirst either due to an inability to speak or not understanding English. The reality is that studies like this only prove what many people already suspect: Neglect in nursing homes is far too common.

Something as easily preventable as dehydration in nursing homes should not be an issue of this scale, causing hospitalizations and deaths. It’s critical for nursing homes to ensure adequate staffing and train their employees to know the signs and symptoms of dehydration.

Take Legal Action for Dehydration in Nursing Homes

The dehydration of the elderly population in the nursing home may be the result of neglect or abuse by staff members. Proper nursing home care depends on properly hydrating the patients.

When someone you love has suffered from nursing home neglect, it’s important to take legal action. Filing a nursing home abuse or neglect lawsuit can help you take justice against those responsible for harming your loved one and help ensure others won’t have to suffer.

A successful nursing home abuse lawsuit provides financial compensation for your loved one’s injuries that can help pay for treatments and other costs. Past lawsuits have awarded hundreds of thousands of dollars, if not millions.

Get a free case review today to see if you or your loved one may be entitled to compensation.

Nursing Home Abuse Support Team
Julie Rivers HeadshotReviewed by:Julie Rivers, MBA

Eldercare Advocate & Expert

  • Fact-Checked
  • Editor

Julie Rivers is an eldercare advocate with over 15 years of dedicated service to victims of nursing home abuse and neglect. Her journey in this field became deeply personal when she assumed the role of an unpaid caregiver during her mother’s battle with Alzheimer’s disease.

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

  1. Cleveland Clinic. (2021). Dehydration. Retrieved March 16, 2021 from https://my.clevelandclinic.org/health/treatments/9013-dehydration
  2. Gaunt, A. (2020). Dehydration in the Elderly: Signs and Prevention. A Place for Mom. Retrieved March 15, 2021 from https://www.aplaceformom.com/caregiver-resources/articles/elderly-dehydration
  3. Kayser-Jones, J., Schell, E. S., Porter, C., Barbaccia, J. C., & Shaw, H. (1999). Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. Journal of the American Geriatrics Society, 47(10), 1187–1194. Retrieved March 15, 2021 from https://doi.org/10.1111/j.1532-5415.1999.tb05198.x
  4. Lehman, S. (2015). Nursing home patients more likely to be dehydrated. Reuters Health. Retrieved March 15, 2021 from https://www.reuters.com/article/us-nursing-homes-dehydration/nursing-home-patients-more-likely-to-be-dehydrated-idUSKBN0L02IY20150127
  5. Martindale. (2011). Dehydration, A Silent Killer of Nursing Home Residents. Retrieved March 15, 2021 from https://www.martindale.com/health-care/article_Slater-Zurz-LLP_1316198.htm
  6. Mayo Clinic. (n.d.) Dehydration. Retrieved March 15, 2021 from https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086