Dehydration Injuries in Nursing Homes

Dehydration occurs when a person loses more fluids and water than he or she takes into their body. Sounds like a pretty easy concept, right? Well, it is a little bit more complex than that in dealing with patients, particularly nursing home patients.

Some minimum level of diligence is required to ascertain that nursing home victims have not lost fluid in their body in a way that may jeopardize good health. Too many nursing homes fail at this simple requirement of making sure that their residents do not have symptoms of dehydration that could cause serious injury or death.

If you believe that you or a loved one suffered a serious injury, or has died as the result of nursing home neglect, call one of our lawyers at (800) 553-8082, or get an online consultation here.

Every process in the body relies on water for proper function; in fact, approximately 75 percent of the body's blood vessels and cells contain water. Fluids are constantly lost through sweat, urine, defecation, and breath. It must be replaced via fluid intake.

Dehydration is pandemic in nursing homes. At least 33 percent and up to 85 percent of the country's 1.6 million nursing home residents suffer from dehydration or malnutrition on a yearly basis.

There is no doubt that most dehydration is not life threatening or even particularly dangerous. But when a patient has symptoms consistent with a hydration problem, something has to be done to protect the patient. Because severe dehydration is more likely to be fatal than a heart attack for nursing home patients.

The big problem in nursing homes that causes dehydration to get out of control is a lack of individualized care - poor staffing and supervision are cited as the two biggest contributors.

Inconsistent care and inadequate staffing to ensure residents drink enough fluids are directly responsible for many cases of dehydration in nursing homes.

So what should a nursing home do for patients who are at risk for dehydration?A nursing home has to develop a plan of care to prevent the at-risk resident from becoming dehydrated. The standard of care requires the nursing home to monitor and assess the resident to determine if she is not getting enough fluids. This is how nursing home can stop a problem before it starts. If the resident is monitored consistently and properly, a dangerous path can be diverted before severe dehydration occurs.

It is a simple thing to do. Another required approach to prevent dehydration is the monitoring of urinary output. The medical staff should also take regular blood tests are being done to ascertain whether their sodium, BUN and creatinine levels show a state of dehydration.

You will also see nursing homes simply manufacturing medical records that show proper monitoring. Things like electrolytes and renal function studies that are electronically measured and recorded just do not jive with the hand-written records of intake and output. What happens? The records reflecting fluid intake are entirely made up by a staff that is just going through the motions.

You win nursing home cases because these facilities rarely follow their own rules. Nursing homes are required to enact care plans that they must follow to treat the conditions of their residents, including dehydration. Far too often, they will not follow the most basic instruction in the own guidelines for patient care. They also fail to meet the minimum standards of care for nursing homes that are established by federal (OBRA) and Maryland law.

What happens? Poor staffing leads to patients being fed too fast or forcefully without any mind to how much was consumed. If you are not paying attention to how much the patient is getting, it is unlikely that you are going to think to order commercial liquid oral supplements when residents don't eat or drink what they should.

All of this is a long-winded way of saying "Care for your patients." Be mindful of how they are doing. Care about them as individual people. Few nursing homes that are doing this are going to miss signs and symptoms of dehydration even if they have no idea what the signs and symptoms are.

Your loved one may be dehydrated if he or she:

• suffers from headaches;
• complains of thirst;
• has decreased blood pressure;
• is dizzy or faint;
• shows a loss of appetite;
• has an increased heart rate;
• appears confused, fatigued, depressed, or otherwise low-mood state;
• has dry skin, mouth, or hair;
• has decreased urine output;
• has sunken eyes;
• has increased body temperature;
• appears groggy or sleepy;
• has skin that shrivels and wrinkles;
• suffers from seizures;
• is delirious;
• falls into unconsciousness;
• has swelling of the tongue;
• appears lethargic.

There are many possible causes of dehydration in nursing home residents. These include:

• decreased fluid intake
• side effects of medications such as diuretics
• decreased kidney function; swallowing disorders
• inadequately provided tube feedings
• the absence of fresh water available
• failure by staff members to open cartons of juice or milk
• decreased thirst sensation; and
• increased fluid loss due to infections, fever, and diarrhea.

Residents at risk include those with Alzheimer's or other dementia, those suffering from illness like the flu or colds, and those with incontinence issues. Others who may be at increased risk also include:

• psychiatric disorders
• a history of dehydration
• four or more chronic conditions
• ill with vomiting and/or diarrhea
• had a recent stroke
• suffer from malnutrition
• repeated infections,
• chronic cognitive impairment
• using anti-depressants, laxatives, diuretics, steroids, or anti-anxiety medications.

Proper hydration levels are key to good health for all of us. The state of dehydration leads to many injuries and other possible complications such as:

• pneumonia;
• urinary tract infections;
• confusion;
• decubitus ulcers/pressure ulcers/bed sores
• disorientation;
• weakness which can lead to falls;
• electrolyte imbalances;
• death

If someone you love has injuries from dehydration or another nursing home injury such as bed sores, a broken hip or fall, and you believe the injury or death was caused by nursing home negligence, you might want to discuss your claim with an attorney.

Call our Maryland nursing home attorneys at (800) 553-8082. Alternatively, you can get a free Internet consultation to discuss what happened in your case. The consultation is free and, if you become a client, there are no fees or expenses unless a recovery is obtained for you.

• Value of Nursing Home Cases
• Picking a Maryland Nursing Home: thoughts and information on choosing a good nursing home for you or your loved one.
  • More: New York Times article