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Tip of the Week: Eleven tips for cutting the risk of dehydration in residents

Contemporary Long-Term Care Weekly, December 27, 2007

Based on the findings of a study that looked at nutrition and hydration in nursing home residents, Jeanie Kayser-Jones, RN, PhD, FAAN, makes 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. Medical and nursing schools should include content on the diagnosis and management of swallowing disorders in their curricula.

3. Nursing homes should provide inservice education programs on the importance of adequate fluid intake, and they should teach their staff members how to give beverages safely.

4. Staff members should provide residents with a variety of beverages of their choice.

5. Staff members should make beverages available and accessible to residents throughout the day.

6. 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.)

7. Professional staff such as registered nurses (RNs) and licensed vocational nurses (LVNs) should supervise the fluid intake of residents.

8. 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.

9. Nursing staff should accurately measure intake and output of all fluids for any residents who are at risk for dehydration.

10. Nursing homes should develop a systematic plan to ensure adequate fluid intake for residents. If, for example, residents drink between 300-450 ml (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.

11. 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, Kayser-Jones says.

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