Dehydration

Dehydration in the Nursing Home

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.

Dehydration in the nursing home happens when the nursing home resident passes their urine and doesn’t drink enough water to compensate for their losses. The body is always losing water through urine, stool, breathing, and sweat. If these fluids are not replaced, the body will eventually not contain enough water to perform vital bodily activities.

When the elderly nursing home resident becomes dehydrated, they are likely to have a certain set of symptoms and health complications from not having enough fluid. Some elderly people will not have a strong thirst drive and will not 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.

Nursing Facility 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 forty nursing facility residents was monitored to see how much they drank.

It was discovered that nearly all of the nursing home residents suffered from inadequate hydration. In addition, 25 of the 40 participants suffered from diseases that may have been caused or exacerbated by their being dehydrated.

The Causes of Dehydration in the Elderly

There are several causes of dehydration in the elderly population of the nursing home and it can depend on the individual. Very often, there are several reasons why the elderly person is dehydrated that combine to make the condition worse.

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. In addition, it may not be possible for the nursing home resident to state what specific fluid they are interested in drinking. Those elderly residents who can’t state what their fluid preferences or needs are may not be able to speak at all or may have language barriers that prevent them from doing so.

Additional reasons for dehydration in the elderly population of a nursing home may be the result of inadequate supervision of their drinking behaviors and the lack of staff members to help the resident drink all that is needed to drink. This is partly caused by the high level of staff turnover seen among certified nursing assistants who work in the nursing home.

In addition, the support staff for the elderly residents don’t always have the proper amount of supervision. Because of this, the certified nursing assistants may miss opportunities or avoid opportunities to offer liquids to their elderly residents.

Symptoms of Dehydration in the Elderly

Symptoms of dehydration in the elderly may get worse over time (1). While the symptoms vary according to the exact age and physical background of the nursing home resident, most of the symptoms of dehydration in the elderly are the same across cultures and those with different health conditions.

The symptoms of dehydration should be identified by staff members, treated accordingly and continually monitored for the resident’s ongoing safety.

Typical symptoms of the early stages of dehydration in the elderly population include the following:

  • Having a sticky and dry mouth
  • Being thirsty or expressing thirst
  • Having dry, papery skin that tents when it is pressed on
  • Having a decrease in the urine output and the frequency of urination

Symptoms of the late stages of dehydration in the elderly population include the following:

  • Being confused and irritable
  • Being unable to sweat
  • Having sunken eyes and cheeks
  • Suffering from low blood pressure
  • Having a fast rate of breathing
  • Being unconscious
  • Suffering from delirium

Complications Resulting From Dehydration in the Elderly

In the setting of the nursing home, being dehydrated often goes along with being malnourished.

According to statistics, 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 of dehydration in the elderly include the following:

  • Seizures. An elder who is dehydrated may experience a loss of consciousness and tonic clonic seizures.
  • Brain swelling. 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.
  • 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.
  • Coma. If the dehydration is very severe, the person may suffer from irretrievable health complications leading to unconsciousness and death.

Dealing with Dehydration in the Nursing Home

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.

If the nursing home resident is not adequately hydrated, the nursing home staff need to be aware of the issue and may be held accountable for the problem.

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Dr. Christine Traxler

Christine Traxler, MD is a retired family practice physician, graduate of the University of Minnesota School of Medicine in 1986, and freelance writer, having worked with patients in rural Minnesota for two decades. She has written several books on medical topics and currently resides in Minneapolis, MN, where she works as a freelance writer on medical topics.

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