scholarly journals CLINICAL INTERVENTIONS TRACK: DRINKING, FLUID INTAKE, AND DEHYDRATION IN OLDER PEOPLE

2015 ◽  
Vol 55 (Suppl_2) ◽  
pp. 594-594
Keyword(s):  
Older People ◽  
Fluid Intake ◽  
Clinical Interventions ◽  
Drinking Fluid

scholarly journals Beverage Type and Hydration Parameters in Older Persons Following a Texture-Modified Diet and Living in Long-term Care Residences

2020 ◽  
Author(s):  
Jose CE Serrano ◽  
Meritxell Martín-Gari ◽  
Jèssica Miranda ◽  
Anna Cassanye ◽  
Mireia Badia ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Water Intake ◽  
Long Term Care ◽  
Fluid Intake ◽  
Daily Intake ◽  
Plain Water ◽  
Term Care ◽  
Modified Diet

Abstract Background: Dehydration due to insufficient fluid intake is a common feature in older adults, a situation that is exacerbated in those who follow a texture modified diet. Most studies have been focused on the total amount of fluid intake without taking into consideration hydration capacities from different beverages. This study aimed to evaluate which is the relationship between the intake of different beverage types and their relationship with hydration parameters in older adults. Methods: A prospective observational study in 22 volunteers that followed a texture-modified diet and thickened liquids with a monthly follow-up for 4 months was performed with older people living in long-term care residences. Beverage intake was assessed daily, and hydration parameters were determined at the end of each month. Results: 50% of the volunteers presented an inadequate fluid intake (< 90% of the recommended daily intake of 30 mL/kg of body weight). Gelatine was the preferred hydration drink, providing 54% of the water intake outside the diet, while water and fruit juices constituted approximately 18% of the intake each, and other beverages such as milk and yogurt, the remaining 10%. No correlation was observed between the total amounts of liquids taken during the day with any of the biomarkers of hydration analysed. Contrary, plain water intake inversely correlated with blood levels of sodium (r= -0.25), and Angiotensin-Converting-Enzyme (ACE) activity (r= -0.29); while gelatine directly correlated with haematocrit (r= 0.25). Since different beverages were consumed during the day, cluster analysis was performed to determine patterns of beverage intake. Three patterns of beverage intake were identified, mainly high in plain water, high in gelatine, and mixed beverage intake. The pattern with a higher intake of gelatine, as a source of water, reported the worst parameters of hydration. Similarly, it was observed that a pattern with high plain water intake showed higher levels of fluid intake. Conclusions: It was concluded that besides the focus on total fluid intake, an appropriate selection of beverages is another important criterion that should be taken into consideration for hydration in older people.

scholarly journals Beverage Intake and Drinking Patterns—Clues to Support Older People Living in Long-Term Care to Drink Well: DRIE and FISE Studies

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 447 ◽  
Author(s):  
Oluseyi Jimoh ◽  
Tracey Brown ◽  
Diane Bunn ◽  
Lee Hooper
Keyword(s):  
Older Adults ◽  
Food Safety ◽  
Older People ◽  
Long Term Care ◽  
Fluid Intake ◽  
Hydration Status ◽  
Drinking Patterns ◽  
Term Care ◽  
Mortality And Morbidity

Low-intake dehydration, due to insufficient beverage intake, is common in older people and associated with increased mortality and morbidity. We aimed to document the drinking patterns of older adults living in long-term care and compared patterns in those drinking well with those not drinking enough. One-hundred-and-eighty-eight people aged ≥ 65 years living in 56 UK long-term care homes were interviewed and hydration status was assessed in the Dehydration Recognition In our Elders (DRIE) study. In 22 DRIE residents, the Fluid Intake Study in our Elders (FISE) directly observed, weighed and recorded all drinks intake over 24 h. Twenty percent of DRIE participants and 18% of FISE participants had low-intake dehydration (serum osmolality > 300 mOsm/kg). Mean total drinks intake was 1787 mL/day (SD 693) in FISE participants (2033 ± 842 mL/day in men; 1748 ± 684 mL/day in women). Most drinks intake was between meals (59%, including 10% with medications). Twelve (55%) FISE participants achieved European Food Safety Authority drinks goals (3/6 men drank ≥ 2.0 L/day, 9/16 women drank ≥ 1.6 L/day). Those drinking well were offered beverages more frequently and drank more with medications and before breakfast (beverage variety did not differ). Promising strategies to support healthy drinking include offering drinks more frequently, particularly before and during breakfast and with medication.

5 Quality Improvement Project (QIP): A Teamwork Approach to Optimise Fluid Intake in Older Inpatients #ButFirstADrink

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
N Vourliotis ◽  
K Grimshaw ◽  
R Harris
Keyword(s):  
Older People ◽  
Behaviour Change ◽  
Fluid Intake ◽  
Time Series Data ◽  
Series Data ◽  
Post Intervention ◽  
Improvement Project ◽  
Age Related ◽  
Older Inpatients ◽  
Knowledge And Attitude

Abstract The shortfalls of hydration management have been widely exposed since the Frances report in 2013. Age-related changes create challenges for people to drink adequate fluid amounts (Nazarko, 2018), making dehydration prevention in older people an ongoing public health priority (NICE, 2016). Hydration needs of older people are complex and may not be fully understood. A proactive MDT approach to facilitate regular drinking opportunities seems an achievable solution to increase hydration awareness, knowledge and daily fluid intake in older inpatients. A QI methodology was used, including stakeholder engagement and PDSA learning cycles to influence, engage and educate staff on hydration management. Outcome measures: Fluid intake (ml/day), number of drinks/days based on fluid balance chart recordings. Interventions: Sharing the #ButFirstADrink social media hydration movement, which includes educational posters, flyers and a YouTube video. Face to face drop-in education sessions were implemented using local hydration education resources from Age UK Salford and GM nutrition and hydration programme as teaching tools. SPC charts were used to show a time-series data. In 15 weeks, 461/525 fluid charts were reviewed from 169 patients. Mean age was 84 years and 68% females. Average daily fluid intake increased by 25% (exceeding aim) indicating 176mls more fluid was offered on average/day. Mean number of drinks/days increased from 4.6 to 6 post interventions. Knowledge and attitude improved in some areas; however fluid output is not routinely recorded. Post intervention, 89% of staff felt that offering a drink at first contact is a suitable hydration promotion campaign. The project scored 58% using the NHS sustainability model (ACT Academy, 2018) suggesting reason for optimism. As it is a behaviour change project, further engagement and momentum is dependent on ongoing enthusiasm to drive the #ButFirstADrink approach. This intervention is free, simple and innovative and stimulates behaviour change, raises drinking awareness and increases hydration.

scholarly journals Hydration Interventions for older people living in residential and nursing care homes: overview of the literature

2019 ◽  
Vol 131 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Glenda Cook ◽  
Philip Hodgson ◽  
Juliana Thompson ◽  
Lesley Bainbridge ◽  
Amy Johnson ◽  
...  
Keyword(s):  
Social Sciences ◽  
Older People ◽  
Nursing Care ◽  
Fluid Intake ◽  
Care Home ◽  
Care Homes ◽  
Cochrane Library ◽  
Older Person ◽  
Cognitive Problems ◽  
Applied Social Sciences

Abstract Introduction Care home populations experiencing high levels of multi-morbidity and dementia require support from caregivers to meet their hydration requirements. This article provides an overview of literature related to hydration interventions and highlights gaps in knowledge. Sources of data This paper draws on UK-focused literature from Applied Social Sciences Index and Abstracts (ASSIA), CINAHL, Medline, Proquest Hospital Premium Collection, Cochrane Library and RCN databases on hydration interventions for older people living with multi-morbidity and dementia in care homes. Areas of agreement Fluid intake is too low in care home residents, and no single hydration intervention is effective in addressing the complex problems that older residents present. Areas of controversy There is a lack of consensus about how much fluid an older person should consume daily for optimum health. There is also lack of agreement about what interventions are effective in supporting individuals with complex physical and cognitive problems to achieve daily fluid intake targets. Growing points To improve hydration care for residents, care home teams should be competent in the delivery of hydration care, and work closely with integrated multi-professional healthcare specialists to provide proactive case management. Areas timely for developing research There is a need for understanding of what hydration practices and processes are effective for care home residents and including these in multi-component interventions.

Consultant Pharmacist Case Management of Older People in Intermediate Care: a New Innovative Model

2016 ◽  
Vol 4 (1) ◽  
pp. 46 ◽  
Author(s):  
Ruth Miller ◽  
Carmel M Darcy ◽  
Anne Friel ◽  
Michael G Scott ◽  
Stephen B Toner
Keyword(s):  
Case Management ◽  
Older People ◽  
Cost Savings ◽  
Community Services ◽  
Rank Test ◽  
Intermediate Care ◽  
Clinical Interventions ◽  
Care Plans ◽  
Health And Social Care ◽  
Medication Appropriateness

Rationale, Aims and Objectives: In 2011, ‘Transforming Your Care’ outlined the remodelling of Health and Social Care in Northern Ireland (HSCNI) UK, specifically recommending better integration of hospital and community services for older people. This work aimed to evaluate consultant pharmacist case management for older patients admitted from acute to intermediate care continuing back into the community setting, given the importance of such a transition to person-centered healthcare.  Method: On transfer to intermediate care, the consultant pharmacist determined the Medication Appropriateness Index (MAI) for each drug prescribed. Individualised pharmaceutical care plans were implemented with clinical interventions recorded and graded using Eadon criteria. Cost savings resulting from interventions which prevent medication errors/Adverse Drug Events (ADEs) have been estimated using the model as described by the University of Sheffield School of Health and Related Research (ScHARR); these were applied. Drugs stopped/started were costed using the NHS dictionary of medicines and devices (dm+d). Case management continued via communication with GPs and/or community pharmacists and post-discharge patient telephone calls/home visits.  Results: Three hundred and fifty-five patients had 3674 drugs assessed for medication appropriateness; both individual and total drug MAI scores on admission to and discharge from intermediate care, were significantly reduced (Wilcoxon signed rank test, p<0.001, n=355). An average of 2.5 clinical interventions per patient were made, with 84% being self-graded as Eadon ≥ Grade 4 (significant interventions resulting in improved care standards). Clinical interventions yielded potential savings of £63-144k pa whilst annual drug cost savings were £68k. Conclusion: This project demonstrated consultant pharmacist case management results in both cost savings and more appropriate prescribing with safer, seamless and more person-centered care.

scholarly journals Preventing and Managing Hydration and Dehydration in Older People

2021 ◽  
pp. 87-98
Author(s):  
Vilborg Kolbrún Vilmundardóttir ◽  
Sigrún Sunna Skúladóttir
Keyword(s):  
Older People ◽  
Nursing Care ◽  
Fluid Therapy ◽  
Best Practice ◽  
Fluid Intake ◽  
Intravenous Fluid ◽  
Special Focus ◽  
Intravenous Fluid Therapy ◽  
Nutritional Care ◽  
Hydration And Dehydration

AbstractPrevious chapters have described nutritional care in geriatrics and orthogeriatrics in detail, including special focus on malnutrition and best practice in nursing care. This chapter will focus on recommendations and guidelines for hydration, fluid intake and intravenous fluid therapy in geriatrics and orthogeriatrics.

The Application of Laboratory Formulas to Clinical Voice Management

1995 ◽  
Vol 4 (2) ◽  
pp. 62-69 ◽  
Author(s):  
Katherine Verdolini ◽  
Ingo R. Titze
Keyword(s):  
Fundamental Frequency ◽  
Voice Disorders ◽  
Clinical Interventions ◽  
Case Examples ◽  
Interactive Nature ◽  
Mathematical Formulas

In this paper, we discuss the application of mathematical formulas to guide the development of clinical interventions in voice disorders. Discussion of case examples includes fundamental frequency and intensity deviations, pitch and loudness abnormalities, laryngeal hyperand hypoadduction, and phonatory effort. The paper illustrates the interactive nature of theoretical and applied work in vocology

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