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Dehydration occurs when a person's loss of body fluids exceeds their intake of fluids. Like malnutrition, dehydration can lead to a variety of serious health problems, such as confusion and disorientation, urinary tract infections, bedsores, pneumonia, and even death.

Increasing age is a major risk factor for dehydration. In fact, people between the ages of 85 and 99 years are six times more likely to be hospitalized for dehydration. It is very important that healthcare providers in nursing homes recognize that the elderly are at risk for developing dehydration and do everything possible to avoid it.

Signs that may indicate that your loved one is suffering from malnutrition and/or dehydration:

  • Weight loss
  • Cracks around the mouth
  • Pale lips and mouth
  • Complaints that dentures no longer fit
  • Unexplained confusion
  • Mouth sores
  • Thinning hair
  • Loose, flappy skin
  • Dry skin
  • Sunken eyes
  • Urinary tract infection
  • When the resident eats or drinks more when a friend or family member assists with feeding
  • If you observe patients being fed in a circle by one nurse's aide. This could indicate that there is not enough staff to ensure all residents are eating enough food and drinking enough liquids.

A person at risk for dehydration should have a hydration program in place at the nursing home -- assisting the person with drinking, offering fluids at mealtime and in between meals, looking for signs and symptoms of dehydration, notifying the physician if such signs and symptoms are present, recording the residents' state of health, and replacing fluids intravenously when the physician deems it necessary, etc..

Negligence Related to Malnutrition and Dehydration

Two out of five nursing home residents suffer from malnutrition and dehydration for a variety of reasons:

  • Failure of the nursing home to employ enough staff, which results in the staff's inability to properly feed the residents
  • Failure of the staff members to pay enough attention to residents who need assistance with eating
  • Failure of the nursing home to properly educate the staff on nutrition and feeding methods
  • Failure of the nursing home to provide proper supervision over those who help residents eat or drink
  • Relying on liquid supplements instead of making sure each resident eats enough food to get necessary vitamins, minerals, protein, and calories

If you notice that your loved one has signs of malnutrition or dehydration, or if you think they are not getting enough food or fluids at the nursing home, you should notify the nursing staff immediately and the physician to prevent potentially serious, life-threatening consequences. In addition, patients in nursing homes often need more water than the average person because of the medications they take.

Tips to Prevent Malnutrition and Dehydration

  • Make sure your loved one in a nursing home drinks plenty of water. Eight glasses a day is recommended, unless there is a medical reason for restricting fluids. In addition to water, your loved one should drink plenty of juice.
  • Insist on a pitcher of water and cups in the room. Make sure the resident can handle the pitcher and cups. If needed, insist on oversized cups with lids and built-in straws.
  • Make sure your loved one eats three well-balanced meals per day.
  • Insist on a daily weigh-in with accurate record keeping. Review weight records to monitor gain or loss.
  • Make sure the food tray isn't placed too far away, making it difficult to reach.

If your loved one shows even one of these signs, you should:

  • Immediately inform the doctor and staff members of your observations.
  • Request a care planning conference with the physician to discuss possible causes for the symptoms and to set up a plan for meals and feeding assistance.
  • Monitor the situation. If it does not improve within days, you should contact authorities to report nursing home abuse.
  • If you even remotely suspect the situation may be life-threatening, take immediate steps to get your loved one to a hospital emergency room.
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