Hydration practices for high-quality dementia care

Drinking an adequate amount of fluid is essential to life. It is therefore self-evident that supporting those who are unable to meet this daily requirement without support is an important component of car. It was illustrated to one of the authors, during her mother’s recent emergency respite admission to a residential care home, that care staff recognised that some individuals need increased support with hydration. It was so reassuring for the family to observe that following an initial assessment by a senior carer that this individual was set a daily fluid target. The target was calculated against evidence based guidelines. Throughout her stay in this care home hydration was flagged as a significant aspect of her care. Also, drinking an adequate amount of fluid was discussed with her, and all her visitors. Having the opportunity to be involved in her care, whilst in the care home, was really welcomed by the whole family. The decision to agree to the respite care admission had been very difficult and supporting her to drink adequate fluids was something that the family could all contribute to. She had access to water and other types of drinks throughout the day. Whilst she really enjoyed the nutritious smoothies and iced fruit juices that she was offered, we were also able to offer advice on her preferred drinks. The staff were not aware that a member of the family was a consultant nurse with a particular interest in hydration for vulnerable older people. The practices that she observed when visiting her mother highlighted the in-depth knowledge of this staff group regarding fluid requirements of older people; their flexibility in responding to many difficult and challenging situations when residents refuse to drink or cannot drink. They were compassionate in their responses to residents and worked with family and visitors to identify innovative ways to encourage residents to do a very natural activity – drinking. In contrast to the experience of this women and her family, there are many situations where people with dementia do not drink adequate amounts of fluid. As a consequence residents can be sub optimally hydrated and are at high risk of dehydration. The following discussion explores some of the difficulties that people with dementia can experience, and different ways that care staff can support residents to drink.