The goal of healthy hydration is ensuring that a person’s intake is adequate to meet their needs. This is done through identifying risk factors, assessing those risk factors, developing care plans with measurable goals, and providing interventions to prevent dehydration. Any person residing in a nursing home is potentially at risk for dehydration. The vast majority of persons develop dehydration because of disease processes, rather than from neglect.
This webpage provides information and resources for definitions, identification of risk factors, signs and symptoms of dehydration, evidence-based best practice for implementing hydration management, and a variety of tools, worksheets and forms for everyday use.
- Dehydration refers to a complex condition resulting in a loss of total body water, with or without salt, at a rate greater than the body can replace it. Dehydration is one form of a fluid and electrolyte imbalance.
- Fluid and electrolyte imbalance
- A fluid and electrolyte imbalance is an insufficiency or excess of either water or electrolytes, such as sodium and potassium, in certain body areas.
- Hydration management
- Hydration management is the promotion of adequate fluid balance that prevents complications resulting from abnormal or undesired fluid levels.
- Osmolality is a measure of the osmoles of solute per kilogram of solvent.
- Osmolarity is a measure of solute concentration, defined as the number of osmoles of solute per liter of solution.
Resources Created by DADS
Best Practice Prevention And Management of Dehydration (PDF) provides evidence-based best-practice guidelines for addressing prevention and management of dehydration in the long-term care setting.
Hydration Care: Preventing Dehydration in Long-Term Care Facilities (PDF) includes definitions of dehydration, risk factors, signs and symptoms and preventative measures.
Dehydration Risk Assessment Tool (PDF) helps identify residents at risk for dehydration.
Care plan for dehydration: Dementia (PDF) provides an example of a hydration care plan for a person with dementia and wandering.
Care plan for dehydration: Thickened liquids (PDF) provides an example of a hydration care plan for someone who uses thickened liquids.
Best Practice Hydration Techniques (PDF) includes techniques to use in long-term care facilities to prevent dehydration.
Fluid calculation options (PDF) offers formulas for assessing fluid needs.
Resources from Other Organizations
- AMDA – The Society for Post-Acute Care and Long-term Care Medicine has an extensive selection of educational, informational and problem-solving tools for practitioners and medical directors in long-term care settings.
Academy of Nutrition and Dietetics (AND) provides trustworthy, science-based food and nutrition information for the public and health professional.
- DHN Resources 2014 (PDF) Literature review and references for best practices for hydration
American Medical Directors Association. Dehydration and Fluid Maintenance Clinical Practice Guideline. Columbia, MD: AMDA 2009
Academy of Nutrition and Dietetics. Position Paper of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults in Health Care Communities. Journal of Academy of Nutrition and Dietetics, 2010; 110 (10): 1554-1563.
Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: Ethical and Legal Issues in Feeding and Hydration. Journal of Academy of Nutrition and Dietetics. June 2013 Volume 113 Number 6: 828-833.
Academy of Nutrition and Dietetics. Position Paper of the Academy of Nutrition and Dietetics: Oral Health and Nutrition, Journal of Academy of Nutrition and Dietetics. 2013; 5: 693-701