Residents and staff at a care home for the elderly in Suffolk, UK are convinced that the improvements in residents’ health is because they are now drinking more water after a “water club” was introduced last summer.
The residents at charity-run The Martins care home in Bury St Edmunds, Suffolk, were encouraged to increase their water intake when the water club was introduced by care home staff last summer. They were encouraged to drink between 8 and 10 glasses of water a day, they were each given a jug of water in their room and water coolers were installed throughout the home.
A year ago, 88-year-old resident Jean Lavender struggled to walk, but now she goes outside most days for a walk, and feels 20 years younger. She told BBC News that:
“I feel more alert – more cheerful too. I’m not a miserable person, but it’s added a sort of zest.”
The care home is also seeing fewer falls, significant improvements in health, fewer GP call-outs, reductions in the use of laxatives and urinary infections, less agitation among dementia residents, and residents reporting better quality of sleep.
Wendy Tomlinson, a former nurse who became manager of the home last year, suspected that the low intake of drinking water among the residents was not doing their health any good and with staff devised and introduced the water club. But even she was surprised at the difference it has made.
Tomlinson said on BBC News that the results have been “fantastic”, and that the “whole home buzzes now; there isn’t that period after lunch when everyone goes off to sleep”.
Elderly people are more likely to become dehydrated because hormonal and other physiological changes reduce the ability of their bodies to metabolize water and balance fluid.
Older people are also more susceptible to fluid deprivation because they tend to be on medication that increase water loss (such as diuretics and hypnotics), they get ill more often, or are stressed for other reasons.
Thus an elderly person can be prone to dehydration because of reduced intake or because they lose water more frequently.
Usually, in younger people, feeling thirsty is the solution. While there have been some studies showing that the thirst response is impaired in older people, others have not been so clear. But one thing we do know is that older people who have had strokes, or who are cognitively impaired, are less likely to feel or respond to thirst, making them more prone to dehydration.
According to Water UK, an organization that represents all UK water and wastewater service suppliers at national and European level, the risk factors for dehydration in the elderly are:
- Being over 85 years of age.
- Thirst reduction.
- Problems with access to drink.
- Problems communicating their needs.
- Cognitive impairment.
- Difficulty swallowing.
- Reduced appetite.
- Medications (such as diuretics, laxatives and sedatives).
- Acute pathology (for example, fever, vomiting, or diarrhoea).
- Neglect of caregivers.
While the case of the The Martins care home is not a scientific piece of research, and one might argue that a Hawthorne effect might be taking place (where any intervention brings change, a sceptical scientist might say in this case it could be because of increased attention from carers), it has raised enough concern for cross-bench peer, Baroness Greengross, to become more convinced of her belief that many old people do not drink enough water and it is harming their health.
Greengross wants to see tighter regulation in UK care homes to make sure that residents are given enough water. There is plenty of news about malnutrition in the elderly, but we don’t hear about dehydration:
“We forget about the need for them to have enough water. It shouldn’t be very difficult to change the habits of care staff,” Greengross told the BBC.
Sources: BBC News, Water UK.
Written by: Catharine Paddock, PhD