New research, carried out at the University of East Anglia (UEA), has shown that dehydration in older people could easily be identified as a result of a routine blood test. The current gold standard for diagnosing dehydration is the serum osmolality test but the high costs means that this is not viable for widespread use. However, the UEA research suggests that routine blood tests for sodium, glucose, potassium and urea could also provide an effective test for dehydration.
Dr Lee Hooper of Norwich Medical School pointed out that an estimated 20% of care home residents are dehydrated and this rises to 40% amongst those admitted to hospital. With such high levels of dehydration amongst care home residents, read on to find out more about the steps you can take to improve hydration within your service.
Fluid intake in older people can be reduced for a number of reasons. Poor mobility and lack of manual dexterity can make it harder to make, carry and consume drinks easily and a lack of social contact can mean fewer opportunities to drink arise. Many older people also have a decreased thirst, meaning that they are less likely to be aware of the impulse to drink regularly and, when combined with deteriorating kidney function, the body’s ability to maintain fluid balance can be drastically reduced.
5 Steps to Improve Hydration levels in Your Service
- Identify those at greatest risk. Those who are unable to drink independently or with a decreased thirst impulse, due to dementia, may be at increased risk of dehydration. Therefore you should ensure that residents who are at risk are identified as needing additional support and encouragement, and have a support plan outlining their needs.
- Set fluid targets. The optimum fluid intake for an older person is not less than 1600ml per day, so ensure that fluid targets are set for those at risk. Using fluid intake records will allow you to monitor the total fluid intake for each 24-hour period to ensure that your target is being met.
- Improve access to fluids. Ensure fluids are always within easy reach and are topped up regularly, as well as offering drinks at regular intervals throughout the day. Many service users may only drink at tea and coffee rounds, if not prompted at other times.
- Provide suitable equipment. Providing each resident with the most appropriate drinking vessel for their needs can be a valuable way of improving fluid intake. Have a range of cups and glasses of different sizes and weights, with different handles and the option for a spout with a non-return valve, if needed.
- Involve families. Family members can be an important part of your hydration strategy if they are aware of the importance of good hydration. Service users who are reluctant to drink may be willing to accept an additional cup of tea or a cold drink from a family member as part of their daily visit, which will add to their fluid intake for the day.
Service users’ food and drink requirements form one of the CQC’s Fundamental Standards. Every month, Care Quality Matters focuses on subjects like this to help Registered Managers pass their CQC inspections. Find out more about Care Quality Matters here.