The institutionalized elderly: dry to the bone!

The fluid intake of 57 elderly male and female patients, drawn from psychogeriatric, long-term care and geriatric admission units, was monitored. The fluid intake was determined by direct observation and recording of fluids consumed by each subject over three 24-hour periods. In all cases, regardless of the unit, level of dependency, cognitive or continence status, elderly patients received considerably less fluid than the recommended daily intake of 2000-2500 ml. In the case of patients who were cognitively impaired, dependent and incontinent, fluid intake was less than patients who did not have these impediments. Forty-seven nurses, working on the three units, completed a self-administered questionnaire on the fluid needs of elderly patients. Generally, nurses' knowledge was inadequate in a number of areas such as the signs and complications of dehydration and the fluid requirements of the elderly. A study of this size does not permit general conclusions to be drawn. Nonetheless, if the results are indicative of current practice, nurses do not have a good knowledge of the fluid needs of the elderly, and the low level of fluid intake constitutes a form of neglect.