Understanding Clinical Dehydration and Its Treatment

Thomas, David; Cote, Todd R.; Lawhorne, Larry Wayne; Levenson, Steven A.; Rubenstein, Laurence Z.; Smith, David A.; Stefanacci, Richard G.; Tangalos, Eric G.; Morley, John E.

doi:10.1016/j.jamda.2008.03.006

Cited by 295 publications

(255 citation statements)

References 62 publications

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“…• Plasma urea/creatinine ratio, which appears useful when kidneys function well, but in older populations raised ratios may also be due to renal failure, bleeding, heart failure, sarcopenia, glucocorticoids or high intakes of protein, making it unhelpful in the specific diagnosis of dehydration (American Medical Directors Association (AMDA), 2009; Thomas et al, 2008).…”

Section: The Reference (Or Gold) Standard For Dehydrationmentioning

confidence: 99%

Water-loss dehydration and aging

Hooper

Bunn

Jimoh

et al. 2014

Mechanisms of Ageing and Development

225

136

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This review defines water-loss and salt-loss dehydration. For older people serum osmolality appears the most appropriate gold standard for diagnosis of water-loss dehydration, but clear signs of early dehydration have not been developed. In older adults, lower muscle mass, reduced kidney function, physical and cognitive disabilities, blunted thirst, and polypharmacy all increase dehydration risk.Cross-sectional studies suggest a water-loss dehydration prevalence of 20-30% in this population.Water-loss dehydration is associated with higher mortality, morbidity and disability in older people, but evidence is still needed that this relationship is causal. There are a variety of ways we may be able to help older people reduce their risk of dehydration by recognising that they are not drinking enough, and being helped to drink more. Strategies to increase fluid intake in residential care homes include identifying and overcoming individual and institutional barriers to drinking, such as being worried about not reaching the toilet in time, physical inability to make or to reach drinks, and reduced social drinking and drinking pleasure. Research needs are discussed, some of which will be addressed by the FP7-funded NU-AGE (New dietary strategies addressing the specific needs of elderly population for a healthy ageing in Europe) trial.

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Section: The Reference (Or Gold) Standard For Dehydrationmentioning

confidence: 99%

Water-loss dehydration and aging

Hooper

Bunn

Jimoh

et al. 2014

Mechanisms of Ageing and Development

225

136

View full text Add to dashboard Cite

show abstract

“…Water-loss dehydration, due to inadequate fluid intake, is common in long-term care (1,2), and associated with doubled risk of 4-year disability and a 40% increase in 8-year mortality in US elders (3). In the UK, the Dehydration Recognition In our Elders (DRIE) study (4) found that 20% of care home residents were dehydrated (serum osmolality >300 mOsm/ kg) (5).…”

Section: Introductionmentioning

confidence: 99%

Assessment of a self-reported drinks diary for the estimation of drinks intake by care home residents: Fluid intake study in the elderly (FISE)

Jimoh

Bunn

Hooper

2015

The Journal of nutrition, health and aging

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Objectives:We evaluated the accuracy of a newly developed self-completed Drinks Diary in care home residents and compared it with direct observation and fluid intake charts. Design: Observational study. Setting: Residential care homes in Norfolk, UK. Participants: 22 elderly people (18 women, mean age 86.6 years SD 8.6, 12 with MMSE scores <27). Measurements: Participants recorded their own drinks intake over 24 hours using the Drinks Diary while care staff used the homes' usual fluid intake chart to record drinks intake. These records were compared with drinks intake assessed by researcher direct observation (reference method), during waking hours (6am to 10pm), while drinks taken from 10pm to 6am were self-reported and checked with staff. Results: Drinks intake assessed by the Drinks Diary was highly correlated with researcher direct observation (Pearson correlation coefficient r=0.93, p<0.001, mean difference -163ml/day) while few staff-completed fluid charts were returned and correlation was low (r=0.122, p=0.818, mean difference 702ml/day).

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“…The definition of dehydration is more complex as it can refer to both loss of body water and volume depletion following the loss of body water; it is suggested [14] that it is defined as a complex condition resulting a reduction in total body water. This can be related to both total water deficit ('water loss dehydration') and combined water and salt deficit ('salt loss dehydration') due to both too low intake and excessive/unbalanced excretion.…”

Section: Malnutrition and Dehydrationmentioning

confidence: 99%

Nutrition and Hydration

Roigk

2018

Perspectives in Nursing Management and Care for Older Adults

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Malnutrition and dehydration are important aspects of the care of older people, particularly those in hospitals or in long-term care facilities. Many older people do not eat and drink adequately during hospital stays and, following hip fracture, many patients achieve only a half of their recommended daily energy, protein and other nutritional requirements [1]. This leads to poor recovery and diminished health status and functional ability and results in a higher risk of other complications (Chap. 6).Nurses are the coordinators of the care process, so it is essential that they bring other health-care specialists together as a team to collaboratively provide highquality care that reflects patients' needs for assessment, intervention and health promotion. When an interdisciplinary team (orthogeriatric collaboration) work together care is more successful, improves patient outcomes and reduces the risk of the inhospital and long-term mortality.The aim of this chapter is to increase awareness of nurses' responsibility, within a multidisciplinary team, for assessment and intervention of nutrition and hydration, examine the issues pertaining to nutrition and fluid balance in older people and outline the nature, assessment and interventions relating to malnutrition and dehydration. Learning OutcomesAt the end of the chapter, and following further study, the nurse will be able to:

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Understanding Clinical Dehydration and Its Treatment

Cited by 295 publications

References 62 publications

Water-loss dehydration and aging

Water-loss dehydration and aging

Assessment of a self-reported drinks diary for the estimation of drinks intake by care home residents: Fluid intake study in the elderly (FISE)

Nutrition and Hydration

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