Warning over dehydration as the number of elderly people in hospital on the rise

Residents, hospitals and care homes are being urged to make sure older people have plenty of access to water and other liquids over the summer months.

The recent heatwave meant Brighton and Sussex University Hospitals NHS Trust, over a 24 hour period, saw an increase in patients and at one point it had 29 people requiring admission to the Royal Sussex County Hospital in Brighton.

Dehydration increases the risk of hospitalisation and even death in extreme cases.

A spokesman for the trust said the hospital screened patients for malnutrition, regular assessments for rehydration are carried out and protected mealtimes are used so staff can focus on patients and make sure they are eating and drinking.

It also has a multi-coloured water jug scheme which uses red lids for those who have difficulty drinking, are dehydrated or have dementia.

Dehydration is taken so seriously, the Care Quality Commission (CQC) considers it a serious breach of care when it carries out inspections of care homes and hospitals and could lead to prosecution.

Age UK Brighton and Hove is encouraging older people not to be scared to ask in a store for a drink or a sit down if they start to feel unwell.

It is also asking people with elderly relatives or neighbours to make sure they have regular access to drinks and do not become dehydrated.

Charity chief executive Jessica Sumner said dehydration in elderly people was a constant concern.

She said: “We are seeing people who find themselves getting dizzy and overheated and who may be wearing too many clothes in the hot weather or just overdoing things.

“We are telling them not to be nervous about asking for a drink when in a shop or for a moment to sit down.

“It is also something we would like shopkeepers to think about how they may be able to help, especially those whose predominant customer-base is older.”

Ms Sumner also said it was important to ensure elderly relatives in their own homes were reminded to drink water or other fluids regularly throughout the day and to take into account some may have problems with holding a glass or swallowing.

Jean Calder, whose mother Molly died last month at the age of 94, is also calling for greater awareness of the issue.

Her mother had suffered dehydration at a home a few years ago although she subsequently moved to a different one.

She said: “So many old people die dehydrated and in discomfort. In the end, my mother did not and I am grateful for that.”

Healthwatch Brighton and Hove says although emergency and hospital services are ready to meet extra demand caused by problems developing as a result of the heat, the most important thing is to prevent health issues being escalated in the first place.

KNOW THE SYMPTOMS AND AVOID THE RISKS

DEHYDRATION can be mild, moderate or severe, depending on how much of your body weight is lost through fluids.

Two early signs of dehydration are thirst and dark-coloured urine. This is the body’s way of trying to increase water intake and decrease water loss.

Other symptoms may include dizziness or light-headedness, headache, tiredness, dry mouth, lips and eyes, passing small amounts of urine infrequently (less than under three/ or four times a day).

Dehydration can also lead to a loss of strength and stamina and is a main cause of heat exhaustion.

You should be able to reverse dehydration at this stage by drinking more fluids.

Severe dehydration is a medical emergency and requires immediate medical attention.

People should contact their GP, out-of-hours service or NHS 111 straight away if they have any of the following symptoms.: feeling unusually tired or confused, dizziness when you stand up that doesn’t go away after a few seconds, not passing urine for eight hours, a weak or rapid pulse, fits or a low level of consciousness.

If dehydration is ongoing (chronic), it can affect kidney function and increase the risk of kidney stones. It can also lead to muscle damage and constipation.

SO MANY OLD PEOPLE DIE DEHYDRATED AND IN DISCOMFORT. IN THE END, MY MOTHER DID NOT AND I AM GRATEFUL FOR THAT

By Jean Calder

MY darling mother, who had dementia, died in June. She was 94 and had lived in residential care for almost six years. Before that she was looked after at home.

While in residential care at a different home, she nearly died of dehydration – and in the years that followed I and others battled to maintain her fluid intake.

In the oppressive heat of this summer, I find myself surprised and relieved at the realisation that after so many years of anxiety, I no longer have to worry about her care.

It doesn’t matter who’s on duty, if they’re properly trained or supervised or whether they will notice she is thirsty, ill or in pain. I need have no concern about whether she is clean or how much she drinks – nor whether she will become overheated or develop a urinary tract infection. Nothing can hurt her now.

We recited the 23rd Psalm at her funeral. I know it so well and yet each time I hear it it moves me. I love the idea of my dear old mum in green pastures being led beside still waters, while holding a cup full to overflowing.

So many old people die dehydrated and in discomfort. In the end, my mother did not and I am grateful for that.

I visited her in her nursing home the day before she died and we sat out under a tree in the garden, having a drink and enjoying the sunshine. She was laughing and happy. I’m glad she felt the sunshine one last time.

The final stroke, when it came next morning, was sudden and catastrophic and she never regained consciousness. A&E was as horrible as I remember it from then.

My mother was choking on her own fluids and I did not know how to relieve her. Nurses couldn’t find additional pillows nor even a towel.

However, once they’d located a single room in an A&E observation ward, all was well. Pain relief began, a hospice nurse attended and the palliative care she received was wonderful.

I shall always be grateful for the kindness of the staff. And that I was able to be with her at the end. I was expecting to have to sit by her all night, but it was as if my gentle mother didn’t want me to have the bother. She died peacefully at 7.40pm.

As I sat quietly by my mother’s side, I could see through the open door into the ward. I saw a meal delivered to an elderly woman, who did not drink or eat.

She spun her plate, she lifted her spoon and mashed the food but ate and drank nothing. Someone said: “She’s not eating”.

A while later, an assistant told her cheerily that if she didn’t fancy the mince, she could have some ice cream and jelly. Her face lit up. The assistant then took the first course away and served up her dessert – which the old lady proceeded to spin and mash. Not one spoonful reached her mouth.

Eventually, I could bear it no longer and told a doctor I was sure she couldn’t eat or drink without help. He looked concerned and said that her care home had told them she could. I said, rather pointedly, that might be one reason why she’d ended up in A&E.

I returned to my mother but a few minutes later saw him by the old lady’s side, offering her spoonfuls of ice cream, which she eagerly swallowed. She just needed someone to help her.

After that, my focus was on my mother. However, since mum died, I’ve thought many times of that old lady. I wonder whether, in the heat of this July, she is all right.

Wherever her care home is, I hope someone there is noticing her – and is helping her to eat and drink. For if there’s one thing people with dementia need even more than food and fluids, it’s a champion to fight their corner.