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16th January 2015

A drink to your health!

Senior woman drinking waterRecent research reported in the Journal of the Royal Society of Medicine showed that older people admitted to hospital from care homes were five times more likely to be dehydrated than older people admitted from their own homes. The results were established after compensation for different levels of age and dementia among the two groups.

Age UK commented that this was completely avoidable and unacceptable. The research pointed to the increased risk of death during people's stay if they were dehydrated. It pointed to speculation as to whether this was a misguided attempt by staff to avoid dealing with incontinence, by giving less water to residents. Or it could be that people in care homes were simply choosing to drink less.

Give more water

My experience in regulating care services is that this is a complex area. It is very clear that dehydration leads to a higher risk of many illnesses. The solution is also clear, literally: give more water. Water should be easily accessible at all times, and people should be encouraged to drink often throughout the day. Best practice is for adults to have no less than less than 1.6 litres of fluid per day, but surveys have found that at best most residents only had 2 to 4 glasses (480-960ml) a day.

The reasons could be many: a reluctance of the person to drink, fearing incontinence, forgetfulness, reduced mobility, a different lifestyle in care, or limited access to water. All of these can be remedied, through the supply of easily operated water machines, access to fresh fruit (which is largely composed of water) and staff training and awareness of the importance of hydration. Several care homes began actively promoting hydration according to best practice: they reported evidence to me of increased well-being and reduced falls, and this is mirrored in national research studies.

There is good guidance available to ensure best practice in hydration. The Royal College of Nursing and NHS Scotland have issued standards and guidance, see links below.

Reducing the risk of many ailments

The main message of the guidance is that good hydration results in reduced risk of many ailments, from cancer, pressure ulcers, confusion, constipation, diabetes, falls and many others.

Lastly, hydration is important for us all, so encouraging staff to drink often also is perhaps a good beginning to ensure good hydration for everyone in the care service.


Care Inspectorate – Food, fluid and nutritional care

Royal College of Nursing – Water for Health

Tony Clarke – QCS Expert Scottish Care Contributor

Topics: Scottish Care

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