Helping people to drink enough to stay healthy

Fluids like water, tea, coffee and juice are essential for the body to be healthy. The importance of having enough fluids does not decrease with age. If you are providing care for someone it is important to make sure they are drinking enough to stay healthy.

Adult Nutrition and Dietetics service

The Adult Nutrition and Dietetics service can provide a range of support from tips on managing taste changes, eating when short of breath, managing a dry mouth and guidance fluids (A Fluid Food Fact Sheet)

There is also a guide to Nutrition Support in End of Life Care on the Care Quality Team website  

For swallowing difficulties we would always advise care homes to speak with the GP for a referral to a specialist Speech and Language Therapist. If a texture modified diet is advised / in place we would encourage homes to visit the International Dysphagia Diet Standardisation Initiative, IDDSI website for additional information

If we do not drink enough we can become dehydrated. Dehydrated people are more likely to develop pressure sores, skin conditions, bladder infections, constipation and

confusion or delirium. They may also be more prone to infection or falls.

Older people may not feel thirsty even though they need fluids. This may be more pronounced where the person has dementia, has suffered a stroke or is taking certain medications. Some medications may decrease the sensation of being thirsty or increase urine production.

It is important to remember that the person you are caring for may not be able to tell you when they need a drink, or they may not feel thirsty even though their body needs more fluids.

How can you tell if someone is not drinking enough? Look out for these warning signs

  • has their behaviour changed, for example becoming more confused?
  • are they more tired than usual?
  • are they more unsteady on their feet or dizzy?
  • are they drinking less than usual? For example are they not drinking all of their usual cup of tea?
  • are they passing dark urine or less urine?
  • are they indicating headaches?
  • do they have a dry mouth/nose?
  • do they have dry skin?
  • do they have cramp?
  • have you noticed any coughing or drooling when drinking?
  • could they have a swallowing difficulty that is making it uncomfortable to drink?

How much should someone drink through the day?

  • 6 to 8 glasses per day using a 250ml mug or glass
  • remember that foods high in water, like fresh fruits, vegetables and some dairy products can be an important part of a person’s fluid intake

What you can do to help

  • if the person you are caring for can't manage regular sized drinks try offering small sips often. You could use a teaspoon to offer a little sip. Always refer to the care plan or assessment to understand what the person's needs are
  • offer a drink at every meal
  • think about using different cups e.g. nosey beakers or ones which encourage independence
  • make sure that person is in an upright, supported position for drinking
  • help the person to avoid tipping their head back to drink. Instead encourage them to keep their chin down to make swallowing as safe as possible
  • no-one should be on thickened fluids without a specialist assessment

Support

Malnutrition Helpline

The Malnutrition Helpline puts the public and health and social care professionals in touch with a team of dietitians who can provide advice on a range of issues relating to difficulties with eating and drinking including food access, nutritional supplements, dehydration, screening for malnutrition and pressure ulcers.

The helpline number is 0113 843 0905 and is operated between 9am and 4pm, Monday to Friday.

There is also an email address people can use: lch.malnutrition@nhs.net

Hydration Pack

Leeds Community Healthcare have compiled a Spotting the signs of dehydration information leaflet that contains useful information and advice.

Speech and Swallowing Team – Leeds Community Healthcare

The Community Speech and Swallowing team provide services for people struggling with a range of speech and swallowing disorders.

They have the following resources;

Service Downloads

Community Learning Disability Team Easy Read Leaflet

Community Learning Disability Team Referral Form 

Food Textures Information

General Dysphagia Leaflet

Fluids Consistency Information

IDDSI Changes to Food Leaflet

IDDSI Changes to Fluid Leaflet

Resources

The University of West London - I-Hydrate resource  

React to dehydration on Vimeo   This video is produced by Bassetlaw CCG around hydration and placed on Vimeo for general consumption

Wessex Academic Health Science Network - Hydration at home. Covers dehydration in all settings, especially domiciliary care and provides access to a wide range of free resources.