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 facility is potentially at risk for dehydration.
Risk factors for dehydration include:
- Functional impairment and immobility
- Chronic medical conditions, such as diabetes or kidney disease
- Acute illnesses, diarrhea and/or vomiting
- Medications, such as laxatives or diuretics
- Cognitive impairment
- Dehydration is condition that occurs when there is excessive fluid loss from the body, either due to an illness, exposure to high temperatures, exertion with inadequate fluid intake or use of diuretic medications. Dehydration may be described as low-intake dehydration vs salt-loss dehydration or by the more traditional terms such as hyponatremic, hypernatremic and isotonic.
- Water balance
- Water balance is a state of equilibrium in which the fluid intake from water and other beverages and foods equals fluid losses in the gastrointestinal tract, urine, sweat and other secretions.
- Electrolyte balance
- Electrolyte balance is the critical balance between the concentration in the cells and that in the tissue fluid surrounding the cells of the various inorganic ions. The primary electrolytes in the cells are potassium, magnesium, sulphate and phosphate. Those in the surrounding fluid are mainly sodium, chloride and bicarbonate. This balance is essential to life and is maintained by the active pumping action of the cell membranes.
- Hydration management
- Hydration management is the promotion of adequate fluid balance which prevents complications resulting from abnormal or undesired fluid levels.
Resources Created by HHSC
Evidence-based Best Practice (EBBP) for Healthy Hydration (PDF) provides evidence-based best-practice guidelines for addressing prevention and management of dehydration in the long-term care (LTC) setting.
Signs, Symptoms, and Risk Factors for Dehydration in LTC (PDF) identifies signs, symptoms and risk factors for dehydration.
Dehydration Risk Assessment Tool Example (PDF) helps identify residents at risk for dehydration.
Healthy Hydration Care Plan Highlights and Examples (PDF) provides guidance and examples for developing care plans for people at risk for dehydration.
Best Practice Techniques: Promoting Good Hydration (PDF) includes techniques to use in LTC facilities to prevent dehydration.
References for Healthy Hydration (PDF) is a bibliography of the resources used in developing the QMP Healthy Hydration focus area.
Resources from Other Organizations
Academy of Nutrition and Dietetics (AND) provides trustworthy, science-based food and nutrition information for the public and health professional.
Centers for Medicare and Medicaid Services (CMS): Hydration Critical Element Pathway was developed to guide surveyors in evaluating people at risk for or who have dehydration during a licensing or certification survey. This pathway can also help facility staff in evaluating people living in the facility for dehydration risk.
Hydration Management (2020) is an evidence-based best practice guideline from The University of Iowa Barbara and Richard Csomay Center for Gerontological Excellence.
Best Practices for Nutrition, Food Service and Dining in Long Term Care Homes (2019) is an evidence-based best practice guideline from the Dietitians of Canada Ontario LTC Action Group.
Implementation Toolkit: Good Hydration (2019) is a toolkit based on a quality improvement initiative called “Good Hydration!”, designed by care homes to reduce urinary tract infections through structured drinks rounds.
Hydration Tips for Seniors is an article from AgingCare.com on how to prevent dehydration in older adults.
What’s in the Foods You Eat Search Tool (2017-2018) is a web-based tool developed by the U.S. Department of Agriculture (USDA) that allows people to view nutrient profiles for foods commonly eaten in the U.S.