Abstract
Objective
The aim of this study was to determine the prevalence of low fluid intake in institutionalized
older residents and the associated factors.
Design
This was a cross-sectional study.
Setting and Participants
The study was carried out at a nursing home with a capacity for 156 residents, all
of whom were older than 65 years.
Measures
Data were collected on the fluids consumed by each resident over a period of 1 week.
Information relating to sociodemographic variables and to residents' health, nutrition,
and hydration status was also collected.
Results
Of 53 residents, 34% ingested less than 1500 mL/d. The factors with the greatest correlation
associated with low fluid intake were cognitive and functional impairment, the risk
of suffering pressure ulcers, being undernourished, a texture-modified diet, dysphagia,
impaired swallowing safety, and BUN:creatinine ratio.
Conclusions/Implications
The results obtained highlight the scale of low fluid intake in nursing homes and
also aid to identify and understand the factors associated with this problem. The
findings could help us to develop specific strategies to promote the intake of liquids
and thereby reduce the incidence of dehydration in nursing homes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Which frail older people are dehydrated? The UK DRIE Study.J Gerontol A Biol Sci Med Sci. 2016; 71: 1341-1347
- Reducing hydration-linked events in nursing home residents.Clin Nurs Res. 2003; 12 (discussion 226–228): 210-225
- The institutionalized elderly: Dry to the bone!.Int J Nurs Stud. 1996; 33: 619-628
- Comparison of four standards for determining adequate water intake of nursing home residents.Res Theory Nurs Pract. 2011; 25: 11-22
- 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults.J Am Coll Cardiol. 2009; 53: e1-e90
- Monitoring and complications of enteral feeding.in: Skipper A.E. Dietitian's Handbook of Enteral and Parenteral Nutrition. Aspen Publishers, Rockville, MD1993
- Fluid intake compared with established standards and symptoms of dehydration among elderly residents of a long-term-care facility.J Am Diet Assoc. 1999; 99: 1447-1450
- Characteristics associated with low food and fluid intake in long-term care residents with dementia.Gerontologist. 2005; 45: 74-80
- An intervention to increase fluid intake in nursing home residents: Prompting and preference compliance.J Am Geriatr Soc. 2001; 49: 926-933
- Understanding clinical dehydration and its treatment.J Am Med Dir Assoc. 2008; 9: 292-301
- Age, dependency and other factors influencing fluid intake by long term care residents.J Nutr Elder. 1999; 18: 21-35
- Hypernatremia in the elderly: Relation to infection and mortality.J Am Geriatr Soc. 1981; 29: 177-180
- Plasma hypertonicity: Another marker of frailty?.J Am Geriatr Soc. 2004; 52: 1313-1320
- The frequency, cost, and clinical outcomes of hypernatremia in patients hospitalized to a comprehensive cancer center.Support Care Cancer. 2013; 21: 1871-1878
- Economic burden of dehydration among hospitalized elderly patients.Am J Heal Syst Pharm. 2004; 61: 2534-2540
- A review of the literature on how important water is to the world's elderly population.Int Nurs Rev. 2004; 51 (discussion 134): 159-166
- Definitions of infection for surveillance in long-term care facilities.Am J Infect Control. 1991; 19: 1-7
- Mini-mental state: A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- Functional evaluation: The Barthel Index.Md State Med J. 1965; 14: 61-65
- Improving the sensitivity of the Barthel Index for stroke rehabilitation.J Clin Epidemiol. 1989; 42: 703-709
- The Braden Scale for predicting pressure sore risk.Nurs Res. 1987; 36: 205-210
- Mini nutritional assessment: A practical assessment tool for grading the nutritional state of elderly patients.Facts Res Gerontol. 1997; 4: 15-59
- Accuracy of the volume–viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration.Clin Nutr. 2008; 27: 806-815
- Bioelectrical impedance analysis and other hydration parameters as risk factors for delirium in rural nursing home residents.J Gerontol A Biol Sci Med Sci. 2004; 59: 813-817
- Measuring risk for dehydration in nursing home residents: Evaluation of the dehydration risk appraisal checklist.Res Gerontol Nurs. 2011; 4: 148-156
- The influence of organizational context on best practice use by care aides in residential long-term care settings.J Am Med Dir Assoc. 2015; 16: 537.e1-537.e10
- Nutritional issues in long-term care.J Am Med Dir Assoc. 2008; 9: 476-485
- Hydration & ageing.N Z Nurs J. 1991; 84: 15-17
- Thirst and Sodium Appetite: Physiological Basis.Academic Press, Inc., San Diego, CA1990
- Principles of Anatomy and Physiology. 13th.Editorial Médica Panamericana, Buenos Aires2013
- Dehydration: Biological considerations, age-related changes, and risk factors in older adults.Biol Res Nurs. 1999; 1: 30-37
- Age-associated alterations in thirst and arginine vasopressin in response to a water or sodium load.Age Ageing. 1995; 24: 151-159
- Scientific opinion on dietary reference values for water.EFSA J. 2010; 8: 1459
- Dehydration and Fluid Maintenance in the Long-Term Care Setting. Clinical Practice Guideline.AMDA, Columbia, MD2009
- A study of fluid provision and consumption in elderly patients in a long-stay rehabilitation hospital.J Hum Nutr Diet. 2015; 28: 384-389
- Hydration status of nursing home residents in Taiwan: A cross-sectional study.J Adv Nurs. 2011; 67: 583-590
- Thickened liquids: Practice patterns of speech-language pathologists.Am J Speech Language Pathol. 2005; 14: 4-13
- Risk factors associated with dehydration in older people living in nursing homes: Scoping review.Int J Nurs Stud. 2018; 82: 90-98
- Impact of fluid intake in the prevention of urinary system diseases: A brief review.Curr Opin Nephrol Hypertens. 2013; 22: S1-S10
- Visual contrast enhances food and liquid intake in advanced Alzheimer's disease.Clin Nutr. 2004; 23: 533-538
- A controlled trial of an intervention to improve urinary and fecal incontinence and constipation.J Am Geriatr Soc. 2010; 58: 1504-1511
- Hydration and acute confusion in long-term care residents.West J Nurs Res. 2003; 25 (discussion 267–273): 251-266
- Can a beverage cart help improve hydration?.Geriatr Nurs. 2002; 23: 208-211
- Oral hydration solution effects on fuid status of the elderly.J Nutr Elder. 1996; 16: 1-10
Article info
Publication history
Published online: October 15, 2018
Footnotes
This work was supported by bridge funding for research projects provided by the University of Lleida.
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.