Dehydration in Virginia nursing home patients – yes, we have a problem
My four year old gets dehydrated easily – I must encourage and remind her to drink her water. With encouragement (and a glass or bottle of cold clean water) she will drink up.
My Mother (sorry Mom, telling on you too) gets dehydrated easily – but, with encouragement, and an ice cold glass of water – she too will drink up.
I too do not drink enough water. And no, this post is not a family confessional on hydration or water intake. I promise. It is more important than that.
The Mayo Clinic says the following about dehydration:
Dehydration occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. If you don’t replace lost fluids, you will get dehydrated. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration. This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults. Dehydration also can occur in any age group if you don’t drink enough water during hot weather — especially if you are exercising vigorously. You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.
Yikes. Scary stuff. Can occur easily in older adults…because of conditions and or medications that increase the risk. Well no wonder I get calls every week from loved ones when their mother, spouse or grandmother was admitted to a local hospital for dehydration. It can be a very serious medical condition, and one that effects older adults more quickly. It can also be life changing or fatal in some adults.
But here is the real kicker – it is also almost always PREVENTABLE. Yes, I had to use all caps to get my point across. If your loved one is admitted to the hospital from a nursing home, for dehydration, that means despite paying for 24 hour a day medical care (often to the tune of $4,000 – $20,000 a month), the fundamental need for water is not being met.
So why in 2016 – no wait, how in 2016 – is it possible for someone receiving 24 hour a day supervision and medical care, to not get enough water?
The answer is simple. Under staffing.
I promise the two are related – keep reading.
A baby cries, and a mother or father does their best to figure out what the need is – food, sleep, diaper, etc. The child’s tears are a pretty good indication of need. But if you are a certified nursing assistant, getting paid $10.50 an hour, and you have 30 plus residents on your floor, AND you have to do the following for each resident every shift (transfer, toilet, bathe, feed, wash, transfer again, skin check, transfer again, move, record their ambulations, bowel movements and intake per meal) will you have time to make sure every resident has cold, clean and fresh water and his or her finger tips, and you are encouraging them to drink it? Not unless that resident is crying out and saying – I am thirsty. Do you know many dementia or Alzheimer’s patients that can easily articulate thirst? Nope.
Of course you won’t.
Best case scenario, the CNA can get every resident water 1 time per shift. That is 1 time every 8 hours. And maybe, on a good day, she can hold the drink and straw to a resident’s lips long enough to get 4-5 sips in.
Is 4-5 sips three times a day enough to keep a body healthy and hydrated? Of course not – but because CNAs are over-worked, have too many residents to care for and chart on, they do not conceivably have time to make hydration a priority for residents. So, in turn, our neediest generation – receiving 24 hour a day care, is often hospitalized or killed simply because they were not given enough water.
Does this bother you in America in 2016? I hope it does. It bothers me.
But it happens all the time. And until facilities put people over profit, and hire more direct care staff like CNAs – more and more folks will literally starve or become hydrated in a nursing home that is supposed to be providing the best possible around the clock care.