Dehydration is a recurring problem for residents in nursing homes. Many elderly suffer from swallowing problems which can lead to reduced fluid intake and multiple and serious medical complications. Based on the findings of a study that looked at nutrition and hydration in nursing home residents, consultant Jeanie Kayser-Jones, RN, PhD, FAAN, made the following recommendations to reduce the risk of dehydration:
1. Older people should have 1,500 to 2,000 ml of liquids each day.
2. Nursing homes should provide education programs on the importance of adequate fluid intake, and they should teach their staff members how to give beverages safely.
3. Staff members should provide residents with a variety of beverages of their choice.
4. Staff members should make beverages available and accessible to residents throughout the day.
5. Nursing homes should have enough staff to assist residents who cannot drink independently. Kayser-Jones recommends that certified nursing assistants (CNAs) have no more than two to three residents to feed at mealtime. (That is a big boost from typical staffing levels of one CNA for every seven to nine residents.)
6. Professional staff such as registered nurses (RNs) and licensed vocational nurses (LVNs) should supervise the fluid intake of residents.
7. RNs, physicians, dietitians, and speech pathologists should work with LVNs and CNAs to ensure that residents drink enough beverages safely. Nursing homes cannot delegate this part of care to CNAs, Kayser-Jones says.
8. Nursing staff should accurately measure intake and output of all fluids for any residents who are at risk for dehydration.
9. Nursing homes should develop a systematic plan to ensure adequate fluid intake for residents. If, for example, residents drink between 300-450ml (1 1/2 to 2 eight-ounce glasses) at each meal, and 8 ounces between meals and at bedtime, they would consume 1,620-2,070 ml per day, which meets the recommended minimum amount.
10. Special attention to fluid intake during hot weather is essential, as older people can easily become dehydrated and die if they do not receive adequate fluids, according to Kayser.