Signs or Symptoms of Abuse or Neglect
Dehydration
Dehydration is a major health issue for the elderly which can double the risk of disability, increase the risk of death and extend hospital stays. The most common type of dehydration in the elderly is simple water loss dehydration, (WLD) caused by inadequate fluid intake. Generally, dehydration is completely preventable with consistent hydration.
Elders, especially those suffering from dementia, can be prone to dehydration, which can result in kidney failure and death. Federal nursing home regulations state that a nursing home “must provide each resident with sufficient fluid intake to maintain proper hydration and health.” 42 C.F.R. § 483.25 (j) Clinical signs and symptoms of dehydration can include thirst, less frequent urination, lethargy, convulsions, fatigue, dry mouth, dark or concentrated urine and sunken eyes. Having dementia or diabetes increases the risk of dehydration.
Common labs measuring a patient’s BUN (blood urea nitrogen) is one method of evaluating dehydration. This test is also a measure of renal function, so impaired renal function can result in an increased BUN. Studies consistently report high levels of dehydration in older people. The above study, in England, found that 19% of those in residential care in Norfolk and Suffolk were dehydrated and another 27% had impending dehydration (Siervo et al, 2014).
Lack of adequate staffing can impact the consumption of fluids and food for those patients that require assistance. You should visit the facility around mealtime to make sure your loved one is being assisted properly and ask the nursing staff to push fluids if there are any indicators of dehydration. Also ask the nursing staff to track the percentage of food consumed for each meal