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Dehydration is a serious problem for older adults, which occurs as a precipitating and comorbid condition leading to unnecessary hospitalizations. Adults older than 65 continue to have the highest rates of admissions for dehydration as a primary diagnosis, with those older than 75 having the highest rates at 750 per 100,000 (Agency for Healthcare Research & Quality [AHRQ], 2015). The annual cost estimate for a primary diagnosis of dehydration is >$1.14 billion (Xiao, Barber, & Campbell, 2004), with secondary dehydration raising the cost of a hospitalization (Mentes & Aronow, 2016), suggesting that the cost of dehydration is underestimated.
Current data for inpatient hospitalizations for adults 65 and older indicate that septicemia is increasingly prevalent at 7.6% of admissions (AHRQ, 2017), which is often linked to hydration status and the outcome of a period of chronic under-hydration. Warren et al. (1994) found that 18% of Medicare patients hospitalized with a diagnosis of dehydration died within 30 days and approximately one half died within 1 year of diagnosis. (There have been no recent studies updating this statistic.) Given that dehydration is often a hidden comorbidity in many health conditions of older adults, it is likely that this observation is still valid (Mentes & Aronow, 2016).
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. The current article is a summary of the evidence-based practice guideline Hydration Management (Mentes & Gaspar, 2020), which is available for purchase from The University of Iowa Barbara and Richard Csomay Center for Gerontological Excellence (access www.UIowaCsomayGeroResources. com). The purpose of this evidence-based protocol is to help health care providers in all settings determine adequate oral fluid intake for older adults and to use strategies that will improve and maintain hydration. The need for implementation of the protocol is supported by a prevalence of dehydration among residents of long-term care that has been consistently reported as ranging from 20% to 40% (Hooper, Bunn, Abdelhamid, et al., 2016; Johnson & Hahn, 2018; Lesnik, Piko, Zeleznik, & Bevc, 2017), with the exception of Paulis, Everink, Halfens, Lohrmann, and Schols (2018) who reported a wide prevalence from 0.8% to 38.5%. On a similar note, residents of...