1. Nursing Assistant Monthly Copyright © 2011 Delmar, Cengage Learning. All rights reserved. Hydration & Dehydration August 2011

2. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration Why be concerned? Dehydration in nursing home residents is: common costly usually preventable It can even be life-threatening!

3. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration Why are some older adults at high risk?  May depend on others to bring fluids  May have less sense of thirst  Have less fluid reserves - dehydrate more easily  May forget to drink enough  May limit their fluids to prevent “bathroom accidents”

4. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration How much is enough?  A dietitian should calculate every resident’s fluid needs  This information should be in the nursing care plan  Watch for signs of dehydration (see next slide) and report them to the nurse

5. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration What to watch for  Dry mucous membranes (eyes, mouth)  Constipation - an early sign of dehydration  Dark, concentrated urine  Decreased urine output  Weakness –

6. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration Some words on fluid restrictions  Fluid restrictions are sometimes needed –In some cases of serious heart or kidney disease –At end of life, for comfort  Good mouth care is needed for comfort and hygiene  Never restrict fluids to prevent incontinence

7. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration How to increase fluid intake  Learn residents’ preferences –Hot or cold? Sweet or not?  Remember that these items count as fluid intake: –Gelatin desserts, sherbet, ice cream, ice chips –Soup, coffee, tea

8. Copyright © 2011 Delmar, Cengage Learning. All rights reserved. August 2011Hydration & Dehydration Make it fun!  Decorate a beverage cart –Try a seasonal or monthly theme (examples: Hawaiian luau, Holiday Magic)  Designate special times for drink breaks, especially when it’s hot  If your facility policy allows it, join in! –Sipping is contagious!