To determine the diagnostic accuracy of state, minimally invasive clinical and physical signs (or sets of signs) to be used as screening tests for detecting impending or current water-loss dehydration, or both, in older people by systematically reviewing studies that have measured a reference standard and at least one index test in people aged 65 years and over. 1 Clinical and physical signs for identification of impending and current water-loss dehydration in older people (Protocol)

This study describes the adequacy of water intake among nursing home residents and identifies variables associated with the adequacy of water intake. Ninety-nine nursing home residents were observed for two 24-hour periods to record food and fluid ingested, ingestion behaviors, and function. Mean water intake (based on food and fluid) was 1,968 mL per day, ranging from 597 mL to 2,988 mL. Only eight subjects met their standard water requirement of 1,600 mL/m2 body surface area. Subjects with inadequate water intake were older, more independent, had few ingestion sessions per day, had intact speech, were semidependent with eating, did not drool, and had inadequate nutrient intake.

Dementia is exhibited by both emotional and physical states such as agitation. Chemical restraints, often used for agitated behaviors, are not always effective and produce untoward effects. Baby doll therapy is a nonpharmacologic therapy that can affect agitated behavior in dementia patients, yet a protocol for the therapy did not exist. An implementation protocol for doll therapy for those with dementia was developed and implemented with 16 residents in a dementia care center. Outcomes were measurements of the impact of the dolls on six areas of the resident's behavior and their reactions to the doll. Participants had an increase in level of happiness, activity/liveliness, interaction with staff and others, and ease of giving care. There was also a reduction in the level of anxiety. The increase in happiness was a statistically significant outcome. Baby doll therapy is an effective nonpharmacological approach for improving the well-being of patients with moderate to severe dementia.

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