Saturday, February 1, 2014

Dehydration often a threat to life, health in nursing homes, senior living centers

Drinking Water
 Drinking Water
Water is the source of life, health experts say.  And in those golden years, it becomes even more abundant.  Yet in nursing homes and senior living centers, where often people can't go and get the things they need themselves, water is not available at regular intervals nor in the desirable amounts, causing risks to life and health in nursing homes.

Long-term care facilities are heavily regulated in most states, and yet simple dehydration remains a common cause of injury and even death among seniors.

Keeping patients safely hydrated is the responsibility of those who care for the elderly.  Often this duty is too often neglected.

This writer reflects on a Mother's care at the end of life, in a care facility for dual-diagnosed patients.  The elderly parent had dementia caused from long-term mental health problems as well as physical limitations from a broken hip and arthritis.  There had been no history of kidney problems, and yet these were on the chart just prior to her death.  This daughter, who lived out of state, had been assured by family members that Mother's care was guaranteed; but a routine visit just one week prior to her death found that care had not been given nor the proper vigilance provided by those involved in relating with nursing home staff.

Perhaps the death was premature; perhaps it was not.  An 82-year-old often has years left to live, but life ended far too soon relative to the illnesses prior to the residential care.

Too often family members find the neglect too late, and permanent damage is already done.  In the case of many elderly across the country, and likely around the world, insufficient water is a serious problem at a time when the senior needs special attention to health care needs.

What is dehydration? It is simply stated fluid shortage when a body loses more water than it takes in.  A person can survive only about four days without fluids.

There are many causes for dehydration.  These include diarrhea, frequent urination, sweating and vomiting.  Low levels of fluid in the body causes it to lose electrolytes like potassium and sodium.  These are the elements for the cells to function normally.Dehydration is often caused by vomiting, diarrhea, frequent urination or excessive sweating. In addition, low fluid levels cause the body to lose electrolytes.

The Mayo Clinic reports that mild to moderate dehydration may cause dry mouth, fatigue and dizziness, thirst, dry skin, headache, constipation, decreased urination and more.  There are several signs of dehydration that indicate medical emergency that include confusion or irritability, rapid breathing, dark urine or no urination, sunken eyes, fever, and low blood pressure.   And in the case of more serious dehydration there can be  brain swelling, seizures, shock, kidney failure, coma and death.

When a young person becomes dehydrated additional fluid intake can remedy the problem.  With older, people, however, intravenous hydration with electrolytes may be needed, since the senior is more at risk.  Diabetics are potentially even more than other seniors.

Care staff are required to monitor the fluid level of residents to make sure they are well hydrated.  When a problem occurs, the negligence can create legal problems for the residence and for the workers.  It is a perfect storm for the patient and for everyone, when proper care is not undertaken, including making sure the senior has enough water to remain as healthy as possible in those later years of life.