Dehydration occurs when a nursing home resident loses more water than they take in. The human body requires an adequate amount of fluid to function properly; for example, to regulate body temperature through perspiration, maintain blood pressure, and eliminate bodily waste.

If severe enough, dehydration can lead to confusion, weakness, urinary tract infections, pneumonia, bedsores in bed-ridden patients, or even death. In general, a human can survive for only about four days without any fluids.

Dehydration Risk Factors

Dehydration should be managed through an individualized daily plan to promote adequate hydration based upon identifying the risk factors which include at least the following:

• Alzheimer’s, or other dementia
• Cognitive Impairment
• Major psychiatric disorders
• Deficits in mobility
• Stroke
• Repeated infections, such as MRSA, C-Diff., VRE
• Diabetes
• Malnutrition or inadequate nutrition
• Urinary incontinence
• Past history of dehydration
• Multiple chronic conditions
• Use of medications such as: diuretics, antidepressants, psychotropics, or anti-anxiety medications, laxatives, or steroids
• Acute situations: vomiting, diarrhea and/or fevers

Dehydration in the nursing home population is more frequent for a number of reasons:

• some medications, such as for high blood pressure or anti-depressants, are diuretics and cause a person to release fluids;

• other medications may cause patients to sweat more; a person’s sense of thirst becomes less acute as they age; frail seniors have a harder time getting up to get a drink when they’re thirsty;

• the resident is reliant on caregivers who can’t sense that they need fluids;

• Kidney function diminishes with age and are less able to conserve fluids;

• The Flu, Colds, and other Illnesses, especially one that causes vomiting and/or diarrhea, also can cause elderly dehydration.

Nursing Home Residents Also Suffer from Dehydration Due to Neglect

• Failure of the nursing home to facility to provide adequate numbers staff, which results in the staff’s inability to spend the time to properly feed the residents;

• Failure of the staff members to pay adequate attention to those residents needing assistance with eating;

• Failure to properly educate the staff on nutrition and feeding methods;

• Failure to provide proper supervision over those who provide nutritional services

Nursing Homes Have an Absolute Duty to Ensure that Residents are Properly Hydrated

Federal Law establishes that nursing homes that take Medicare residents provide each resident with sufficient fluid intake to maintain proper hydration and health.
(42 CFR § 483.25 (j)):

Hydration. The facility must provide each resident with sufficient fluid intake to maintain proper hydration and health.

How to Identify Signs of Dehydration

In addition to monitoring resident’s intake of fluid, staff should be on the conducting regular assessments of the resident looking for the following signs of dehydration:

• Dark yellow urine
• Failure to drink fluids provided with meals
• Failure to drink water provided in pictures for resident in room
• Bleeding gums
• Sunken eyes
• Ashen skin
• Dry skin
• Urinary tract infection
• Bedsores/Pressure Ulcers

Weight loss Dehydration

Dehydration should be managed through an individualized daily plan to promote adequate hydration based upon identifying the risk factors which include at least the following:

• Alzheimer’s, or other dementia
• Major psychiatric disorders
• Depression
• Stroke
• Repeated infections
• Diabetes
• Malnutrition
• Urinary incontinence
• History of dehydration
• Multiple chronic conditions
• Use of diuretics, antidepressants, psychotropics, or anti-anxiety medications, laxatives, or steroids
• Acute Illnesses which causes vomiting, fever or diarrhea.

In general “mild dehydration” is defined as a loss of 2% of your body weight. Even mild dehydration can cause cognitive deficits often leading to other issues, including cardiac or renal problems. When a person loses 4% or more of their body weight from dehydration it is considered to “severe dehydration” which places stress on the heart, which is attempting to pump with less fluid. Weighing residents in nursing homes at risk for dehydration daily would help identify loss of weight related to dehydration or malnutrition.

This website is not intended to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation.

If you or a loved one has suffered an injury from neglect or abuse in a nursing home or other care facility that serves the elderly in Minnesota please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to KLaBore@mnnursinghomeneglect.com, or call Ken at 612-767-7503.

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