Dehydrated care home residents a 'systematic problem'

Of 21,000 older people admitted to hospital from care homes, an unusually high number are dehydrated, according to the findings of an Oxford University study.

Published in the Journal of the Royal Society of Medicine and taken from results compiled over a two-year period, the study found high sodium levels in 12 per cent of care home admissions, in contrast to 1.3 per cent from the rest of the population.

Authors of the study suggest that care home staff might be attempting to prevent incontinence by giving residents less fluid, but warn that dehydration means patients are far more likely to die in hospital, often from from heart attacks and pneumonia.

Lead researcher, from the Royal Free London NHS Foundation Trust, Dr Anthony Wolff, comments: “Our study shows that too many patients admitted to hospital from a substantial number of care homes are dehydrated, leading to unnecessary loss of life. High sodium levels in care home residents should raise questions about adequate support for drinking.”

Co-author, Professor Martin McKee, of the London School of Hygiene & Tropical Medicine, calls for more scrutiny of care homes where residents are found to be dehydrated, saying: “This raises serious concerns about the quality of care provided in some care homes. “When a care home has more than a few residents admitted to hospital with high sodium levels this may well be indicative of a systematic problem at the care home and the issue should be raised formally.”

Co-author Professor David Stuckler from the University of Oxford adds: “Clearly this level of dehydration is a problem. Further research is needed to understand why it is occurring. Are care home residents choosing to drink less than they should? Or, as has been speculated, are care home staff not offering enough water to reduce incontinence and the amount of assistance their residents require?”

Executive vice president of care provider Nightingale Hammerson, Leon Smith, offers his own perspective, saying that the study, “highlights the extent of the ethical crisis which currently faces our social care system”.

He continues, “Hydration is, and has for a long time been a major issue with older people who live in care homes. Sadly, residents being denied the basic necessity of water does happen within many care institutions; although this is appalling, it is old news often overlooked by our society.

“At Nightingale Hammerson, nutrition and hydration is a core priority; water and juice dispensers are placed throughout both of our care homes. As well as mandatory dementia training for all our staff, which is not currently a legal requirement, there is also a huge emphasis placed on the importance of hydration. From the day someone takes up residence in one of our care homes, we make sure that all their needs are met – especially the most basic ones!

“We urge the Government to pay more attention to training of care workers – withholding water is clearly abuse and should be dealt with as such.”