The Fatal Consequences of Elderly Dehydration and Urinary Tract Infections
It is common knowledge that water is essential for human life.
Nursing home residents are often at risk for dehydration. Simply stated, dehydration occurs when a person loses more water than they take in. Water deprivation can have serious life threatening consequences. Sadly, in our experience, nursing homes all too often fail to take appropriate measures to prevent this most treatable and preventable condition.
There are many reasons that dehydration occurs frequently in elderly people including physiological changes in the body resulting in loss of protein which holds water, decrease of kidney urine concentrating abilities resulting in frequent urination, and decreasing thirst. Additionally, many medications, including blood pressure medication, anti-depressants and laxatives, cause dehydration. Making matters worse, many elderly nursing home residents are totally dependent upon the nursing home staff to obtain adequate fluid intake as a result of cognitive and physical disabilities.
Most physicians would agree that the minimal standard of care for residents in nursing homes requires the nursing home staff to provide each resident with sufficient fluid intake to maintain proper hydration and health. Nursing homes should develop, implement and (when needed) revise care plans to protect residents from fluid volume deficits. The potentially fatal consequences of dehydration can be prevented if the nursing home staff takes preventative actions including recording daily food and fluid intake, monitoring body weight on a daily basis and implementing a hydration program that provides water during and between meals. The nursing home must carefully and thoroughly monitor fluid and nutritional support and initiate appropriate treatment when intake falls below adequate levels.
Unfortunately, elderly dehydration often goes undiagnosed and untreated in nursing home patients. Fluid volume deficits can have devastating consequences such as causing kidney failure, seizures, swelling of the brain, hypovolemic shock, and increases a resident's susceptibility to urinary tract infections in females. Ultimately, dehydrated nursing home residents may develop sepsis resulting in death because their ability to fight infections has been compromised.
In recognition of the importance of preventing dehydration, the Health Care Financing Administration (also known as the Centers for Medicare & Medicaid Services) has classified dehydration as a "sentinel event" that can trigger a broader investigation of a nursing home by state surveyors. The development of pressure sores (also known as bed sores or decubitus ulcers) is also classified as a "sentinel event."
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