Due to physiological changes as we age, older people are at a greater risk of dehydration. These risks are further heightened by changes to mental capacity and physical frailty. The elderly population are incredibly vulnerable to the consequences of not drinking enough fluids. Changes due to the ageing process may mean that the older person has a reduced sensitivity to being thirsty. If they are not reminded to drink water regularly, then they can easily become dehydrated. Older people who have had a stoke or who have Alzheimer’s disease have a reduced sensitivity and need careful monitoring. Other risk factors include declining renal function, cognitive impairment and the regular taking of laxatives and diuretics.
At Farthings we understand how important it is to ensure that our residents received adequate amounts of fluids to remain hydrated and our staff team know the key signs of dehydration. Common signs of dehydration in an older person could be a dry mouth, sunken eyes, skin that has lost elasticity, drowsiness, disorientation or confusion, low blood pressure and feeling dizzy; one or more of these signs may be seen, along with a reduced urine output.
Whilst the care team at Farthings offer drinks regularly throughout the day and night, we found these regular offerings were not always accurately reflected in the individual residents daily notes.
This got us thinking, so we considered the Bradley and Rees (2003) Red Tray Project, in which utilised red trays to identify people who were ‘at risk’ and who needed additional support whilst eating. There was another campaign by student nurses in south Wales which utilised yellow lids on jugs to identify individuals who were having their fluid balances monitored. Neither of these were quite what we needed at Farthings, as we were looking to easily identify quantities of fluids being consumed which would enable the team to ensure residents were drinking recommended quantities and aid with the reporting of intake too.
Liking the idea of utilising a coloured approach to make recognition easier, it was agreed that a traffic light system would be implemented at Farthings. All individuals who are required to have their fluid intake monitored will be given a 750ml jug of water with a red lid each morning. When the first jug of water has been drunk, it will be refilled with fresh water and the lid will be changed to yellow. When the second jug has been drunk, again it will be refilled, and the lid will be changed to green. At this point the resident will have drank 1500ml of water the risk of dehydration will have been reduced. If the red lid is still on the jug by the afternoon, the senior carer will take further action.
New smaller 750ml water jugs were purchased along with red, yellow and green lids. This will make the jugs easier for residents to pour and will also prevent the water becoming warm as it will be replenished frequently. In addition, new water trays and cups were purchased to keep the hydration set together.
