5 Important Hydration Tips
1. The Importance of Hydration
Dehydration is cited as one of the reasons for hospital admission for more than one million elderly people each year. A single admission can easily cost thousands of dollars, leading to HCFA monitoring of hydration standards and implementation procedures. Large fines are being imposed on LTC facilities for deficiencies involving hydration.
Fluid loss is a serious, even life-threatening health problem for the elderly. Water aids in metabolism, prevents constipation, regulates body temperature, and facilitates digestion. The need for total body water increases with aging because the aging body tends to lose water content over time. An elderly person has less water volume to begin with, and the aging process, along with medications and treatments for the elderly, reduces the desire to drink.
A body weight loss of one percent can cause an increase in body temperature due to dehydration. And dehydration can occur with as little as a two percent loss of body weight.
2. Hydration Programs & Nutricare Beverage Crystals
Nutritionists stress the importance of variety, but that often brings up concerns about costs and the extra time required to mix and prepare exotic drinks – as well as concerns about carbonation, sugar, and caffeine.
Nutricare Beverage Crystals address all of these concerns. They look delicious and provide a variety of flavors: fruit punch, lemonade, cranberry, grape, and orange. But they contain no carbonation, sugar, sodium, or caffeine. They are very inexpensive to serve and easy to prepare. They offer an excellent way to spice up your hydration program while keeping costs and preparation time down.
3. Indicators & Risk Factors
- Cognitive decline
- Needing help drinking from cup or glass
- Trouble swallowing liquids
- Frequent vomiting, diarrhea, or fever
- Increased confusion and weakness
- Decreased skin turgor
- Dry mouth, cracked lips, sunken eyes
- Dark urine or decreased urine output
- Changes in daily weight
- Use of medications involving laxatives, diuretics, and cardiovascular agents
- Renal disease
4. How Much Hydration is Required?
Recent studies have indicated that adults need about 6 cups a day (1500cc) or 30 cc/kg body wt. Illness, diarrhea, or stage II or greater pressure ulcers may increase the need for fluid intake, as will a high fiber diet.
The best sources of fluids are water, juices, and milk. Foods such as ice cream, soup, and gelatin are also good sources. Caffeinated beverages can lead to fluid loss, so they should be avoided as much as possible.
Because research shows that residents get a high percent of their fluid intake needs at meal times, it is very important to make sure that the beverages they prefer are served then.
5. A Preventable Condition
Effective hydration for the elderly requires a proactive approach, using a number of different measures. For example: At intake, ask for new residents fluid preferences, in detail. Don’t just ask, "Do you like milk," but find out whether they like fat-free, low-fat, chocolate, or regular whole milk. Do they like tap water? What temperature do they prefer? Do they like it in a cup, glass, or water bottle?
- Promote fluid intake with each visit to the room.
- Offer a full glass of water with medication.
- Provide a variety of beverages during activities.
- Train staff to take a positive approach. Avoid saying, "Do you want some juice?" Say instead, "Here is some nice juice."
- Make sure a pitcher and cup are within reach.
- Try some exciting juices, smoothies, and teas.
A comprehensive hydration program for your facility would include training your staff in the warning signs of dehydration, identifying residents who are at high risk, estimating each resident’s fluid needs, and documenting mealtime and between-meal fluid intake.