Nursing Home Residents at Higher Risk for Dehydration, Study Shows

A study published recently in the Journal of the Royal Society of Medicine found a higher incidence of dehydration in older people in hospitals and nursing homes. They may not be getting sufficient liquids or be given the help they need to drink.

Older people, particularly the infirm, are at risk for dehydration, especially those in nursing homes or hospitals, who may need help drinking. Nursing home staff sometimes neglect to give people the necessary help in drinking, Nursing Times (nursingtimes.net) reports.

Staff members can easily miss signs of mild-to-moderate dehydration in older people and the problem is often detected only on admission to a hospital, where tests reveal hypernatremia (high plasma sodium). Hypernatremia is a common sign of dehydration. The study linked hospital admissions with nursing home residency to see whether patients from nursing homes are at higher risk for hypernatremia than those living in their own homes. The researchers reviewed records of all patients age 65 and over on first admission to Barnet and Chase Farm Hospitals Trust between January 2011 and December 2013. The data examined included age, gender, admission type (emergency or planned), presence of dementia, and where the admitted patient resided (nursing home or own home).

The researchers reviewed 21,610 admissions and 432 cases of hypernatremia; 1,413 hospital deaths were recorded. The researchers examined the patients’ lab results to see whether the patients were dehydrated on admission and whether they subsequently died in the hospital. People living in nursing homes were 10 times more likely to be admitted to the hospital with dehydration than patients who lived in their own homes. Only 1.3 percent of patients from their own homes had high plasma sodium levels caused by dehydration, compared with 12 percent of patients from nursing homes, according to Nursing Times.

The hospital patients who came from nursing homes were older and more likely to have dementia. Even after the researchers adjusted for age, gender, admission type and presence of dementia, they found the risk of high sodium was five times higher for nursing home residents. While admission from a nursing home was not inevitably associated with hypernatremia, the probability was significantly increased for about a third of nursing homes. Patients who lived in their own homes and did not have dementia were least likely to have hypernatremia, followed by own-home residents with dementia. Next were nursing home residents with no dementia followed by nursing home residents with dementia. The adjusted figures also showed nursing home residents were about twice as likely to die while in the hospital. Hypernatremia itself was associated with a five-fold greater risk of in-hospital mortality.

 

The researchers found that the presence of hypernatremia at hospital admission is animportant predictor of in-hospital mortality. The reasons for this are not clear, but the authors suggest it could be that nursing home residents choose to drink less than they should, or staff members are not offering them enough water in an attempt to reduce instances of incontinence. The authors conclude that too many patients admitted to hospitals from nursing homes are dehydrated on admission, leading to unnecessary deaths, according to Nursing Times.

 

 

 

 

 

The post Nursing Home Residents at Higher Risk for Dehydration, Study Shows appeared first on Parker Waichman -

from Parker Waichman http://www.yourlawyer.com/blog/nursing-home-residents-at-higher-risk-for-dehydration-study-shows/