Effective hydration care for older people living in care homes

Low-intake dehydration is common in all older people because of age-related physical, physiological, cognitive and psychological changes. Risk of dehydration increases in care home residents because of increased need for care and dependence on staff for drinks or help with drinking. Commonly-used signs and symptoms of dehydration are ineffective in identifying dehydration in older people, so should not be used, because they may lead to inappropriate care. Low-intake dehydration can only be diagnosed using directly measured serum osmolality or calculated osmolarity, both of which require venous blood samples. Therefore, preventing low-intake dehydration is key, and all older people should be supported to drink well using a range of strategies based on person-centred approaches to individualised care, by staff trained in hydration care. Individualised approaches include offering preferred drinks more often during the day, using residents’ preferred cups/glasses, increasing drinks intake with medications, drinks before breakfast and supporting excellent continence care.