Understanding the strategies required to meet hydration needs of people living with dementia.
Authors: Murphy, J., Holmes, J. and Brooks, C.
Start date: 18 July 2015
Journal: Alzheimer's and Dementia
Background: Dementia can increase the risk of dehydration as cognitive impairment and old age reduce the ability to recognise thirst. Dehydration can cause further deterioration in cognitive function and other health problems. There is no consensus on recommended fluid intakes for dementia but generally 1500ml per day is regarded as sufficient. However the challenges of meeting appropriate hydration continue to be reported. The aim of this study, using quantitative and qualitative methods was to gain a deeper understanding of the strategies required to understand hydration needs of people living with dementia. Methods: Quantitative measures of fluid intake were recorded over a period of five days in residents (n=18) who were living in care homes. The mean age of the residents was 79 (104-58) years, 50% were women with a diagnosis of a range of dementia types. Qualitative research using a blend of nine focus groups and five semi structured interviews were conducted with all those involved in the care of people with dementia, including nurses, managers, chefs, care workers, family members, dietitians and speech and language therapists. Thematic analysis of transcripts enabled core themes to be explored. Results: The daily intake of fluid was 1065 ± 836 ml (mean ± 2 standard deviations). Fifteen (83%) residents did not meet the recommended fluid intake. The qualitative themes highlighted ways to overcome poor fluid intake and included alternative ways to improve hydration; a person centred approach to delivering fluid with a recognition of psychosocial and cultural influences; communication between front-line staff and key healthcare professionals. Conclusions: Using this combined methodological approach, the results show that new strategies are needed to meet the hydration needs, with a person centred approach to care for people living with dementia. It is important to ensure all staff are well trained and competent to encourage sufficient fluid intake.