Clinical Outcome Measures of Dehydration and Fluid Intake Among Institutionalized Elderly

Abstract

Current literature suggests that established standards for calculating fluid requirements for the elderly may not accurately reflect needs. Therefore, the objectives of this study were to: 1) determine actual fluid intake by a three-day diet history recorded by the dietary and nursing staffs; 2) assess clinical outcome measures of dehydration as well as effect of physical and mental dependency factors on fluid intake; and 3) compare actual intake to four established standards. Food and fluid intake, clinical outcome measures of dehydration, and Minimum Data Set Plus data were collected and analyzed for 121 subjects age 65 to 99 years residing in a long-term care facility with no acute illness. A paired two-tailed t test was used to compare differences between actual and recommended fluid intakes ANOVA was used to determine the relationships between dependency factors and number of medications, and actual fluid intake. Average fluid intake was 1982±549 mL. There were no statistically significant relationships between dependency factors and actual fluid intake. Differences between actual and recommended fluid intake based on standard 1 (30 mL/kg body weight) and standard 2 (30 mL/kg with a minimum of 1500 mL) were not significant. Mean fluid intake was greater than recommended by standard 3 (1 mL/kcal consumed) and less than recommended by standard 4 (100 mL/kg for first 10 kg of body weight; 50 mL/kg for next 10 kg of body weight; and 15 mL/kg for remaining kg of body weight). Standards 1 (when used cautiously in underweight clients), 2, and 4 appear to provide adequate fluid to prevent the appearance of clinical outcome measures of dehydration. Caregivers at this facility may routinely exert added effort in supplying dependent residents with adequate fluid since these residents are thought to be at increased risk for dehydration and may not be representative of all institutions.