TIPS FOR NURSES BY HEALTH CARE SETTING.
Hospital
Ensure that the hospitalized older adult has access to something to drink at all times. Offer fluids regularly, as the older adult may not experience thirst and therefore may not help himself. A water pitcher that is untouched at the end of the shift tells you much about the hydration habits of the older person in your care. Minimizing fasting times for surgery
and diagnostic procedures is also important. In the ED, when appropriate, provide food and fluids to older adults who must wait longer than two hours.
Nursing home
Educate certified nursing assistants on the importance of consistent oral hydration and supervise their care of patients. Provide preferred beverages during group activities or at teatime or nonalcoholic “happy hour,” and use a beverage cart, which can create a social environment that encourages fluid intake. For those with difficulty drinking, the use of positioning strategies, swallowing exercises, cuing, and good oral care should be tried before fluids are thickened for safe consumption. Family members can provide important information about hydration habits and fluid preferences and make
offering fluids (the most successful strategy to increase consumption) a regular part of their visits.
Ambulatory care
Ask older adults about their daily fluid intake and discuss how much fluid to drink on a daily basis, pointing out the need for increased amounts of fluid during exercise, in hot weather, and during illness. Review medications that affect fluid balance and increase or decrease dosages as needed. Recommend to healthy older adults with adequate renal function that they monitor their urine color. Remind older adults who have urinary incontinence that they shouldn’t impose restrictions on their fluid intake to prevent incontinence episodes. Regardless of the type of incontinence, adequate intake of fluid, approximately 1,500 to 2,000 mL per day, is indicated to maintain hydration.
Home care
Assess the types and amounts of fluid the home care patient is consuming. Educate the patient on the best fluids to consume. Educate the family on the importance of hydration and the risk factors for dehydration and ask them to report any instance in which the patient is not eating or drinking as he normally does, as an older person can become dehydrated even after a day of reduced intake.