- Poor oral intake
- Requirement for thickened fluids
- Poor access to fluids
- Inability to independently eat & drink
- Increased fluids losses from conditions such as diarrhoea/vomiting, unstable diabetes, increased urine output etc.
- Impaired cognition
There are a number of clinical signs of dehydration which care staff should be monitoring for; these include dry cracked lips, dry skin, darker urine or reduced urine output, dry oral mucosa, increased confusion and drowsiness. The minimum volume of fluid required for adequate hydration is 1500-2000mls per day; many residents will need prompting and assistance to achieve this. A number of strategies can be implemented in facilities such as ensuring all residents are regularly offered fluids, or ensuring fluids are always within reach.
Strategies to maintain / increase fluid intake
- Ensure all staff are adequately trained in regards to the importance of hydration.
- Regularly offer fluids – e.g. every 1 ½ hours during the day
- Offer fluids at specific routine times e.g. before/after showering, after toileting, before/after physiotherapy, after activities program, with medication rounds etc.
- Regular hydration trolley rounds
- Offer residents their preferred drinks; make sure staff are aware of residents preferences
- Prompt residents to drink at meal times
- Ensure fluid is within residents’ reach
- Educate families / visitors to offer fluids when visiting
- Encourage higher moisture foods such as jelly, custard, yoghurt, ice cream, soup, pureed fruit
- Keep a fluid balance chart, especially for high risk residents
- Use a sticker on trays of residents who need to drink more, to help prompt staff.
- Identify at risk residents and pay more attention to them – e.g. confused, refusing fluids, febrile, on diuretics.
Example Daily Fluid Intake for an Aged Care Resident
|BreakfastMilk on cereal – 200 ml
Cup of Tea – 200 ml
Juice 100 ml
Water offered – 100 ml
Cup of Tea – 200 ml
Cordial Drink – 150 ml
Cup of coffee – 200 ml
Water – 50 ml encouraged when tray cup cleared away
Extra fluid offered
100 ml water/other beverage given by a staff member/visitor
Soup – 150 ml
Milk drink – (e.g. plain, flavoured, supplement) – 200 ml
Water 50 ml offered prior to sleep
50 ml x 3 per day = 150 ml
100 ml Water offered with each medication round – Total 300 ml
Total 2000 ml