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Dehydration is a serious problem for older adults. It occurs as both a precipitating and comorbid condition leading to unnecessary hospitalizations for older adults. In 2008, 9% of all hospital admissions for adults older than 65 were with dehydration as a secondary diagnosis; of the more than 300,000 admissions for dehydration as a primary diagnosis, 50% occurred in adults older than 65 at a cost of more than $2 billion (Agency for Healthcare Research and Quality [AHRQ], 2008 ). Dehydration has been associated with longer hospital stays for rehabilitation (Mukand, Cai, Zielinski, Danish, & Berman, 2003 ) and for hospital readmissions (Gordon, An, Hayward, & Williams, 1998 ) at excess cost (Xiao, Barber, & Campbell, 2004 ). For Medicare patients hospitalized with a diagnosis of dehydration, 18% died within 30 days and approximately half died within 1 year of diagnosis (Warren et al., 1994 ). In addition, dehydration has been designated as one of 13 ambulatory-care sensitive conditions (AHRQ, 2007 ). An ambulatory-care sensitive condition is a health problem that is thought to be best treated by primary care practitioners. Even in healthy community-dwelling older adults, mild dehydration has been found to affect physical performance and cognitive processing (Ainslie et al., 2002 ).
Purpose
Given the serious consequences of dehydration for older adults, gerontological nurses and health care teams must make hydration management a priority in the care of this population. This article is a summary of the evidence-based practice guideline Hydration Management (Mentes & Kang, 2011 ), which is available for purchase from The University of Iowa Hartford Center of Geriatric Nursing Excellence at http://www.nursing.uiowa.edu/Hartford/nurse/ebp.htm. The purpose of the guideline is to help health care providers in all settings determine adequate oral fluid intake for older adults and to use strategies that will maintain hydration (Mentes & Kang, 2011 ). Use of the guideline will help prevent dehydration and associated conditions, such as acute confusion/delirium (Foreman, 1989 ; Mentes, Culp, Maas, & Rantz, 1999 ; O'Keeffe & Lavan, 1996 ), adverse drug reactions (Doucet et al., 2002 ), infections (Beaujean et al., 1997 ; Masotti et al., 2000 ), and increased mortality associated with bladder cancer, coronary heart disease, and stroke (