Dehydration within the nursing home

[richie3210]

Hi, First a little bit about my situation, my dad was diagnosed with Alzeimers about 10 years ago now, for the first 8 years he lived with my small family until he had what was believed to be a stroke (unconfirmed) this resulted in a 12 week stay in hospital.
After this it was decided that it was only fair to find a suitable nursing home for my father as it was becoming increasingly difficult for my partner and I to meet all of dad's needs and it wasn't fair on our young children and putting major strain on our relationship. During our search to find a nursing home my father was granted countinuing health care, along with this came a shortlist of nursing homes within our area, none of which seemed to meet our "expected" standards. When we looked away from the list either the homes were full or to far away from family so we got a placement in a home close to us so we could spend lots of time there ensuring my father's care need were being adequately met. Within 1 month we raised a safeguarding issue and the home was immediately put on stop, following this there was a complete change of management and some staff along with many meetings involving residents family members, management and representatives from the CQC and local authorities, during the coming months lots of thing within the home certainly changed for the better but I still had many reservations and was struggling to build a trusting relationship with anyone there.
About 6 weeks ago it was decided enough was enough and we demanded that another placement was found for my father, this was immediately accepted by the CQC but as of yet we have heard nothing!!


Sorry seems a bit long winded so back to my original topic;
A couple of weeks ago my father was hit with a chest infection, his GP was called and antibiotics prescribed. After finishing the antibiotics he still seemed very chesty and under the weather. A couple of days later I received a phone call late at night saying my father was still chesty and an ambulance had been called and he was being admitted to hospital. On arrival bloods were taken and they showed he is still fighting an infection but also they showed he was severely dehydrated............how could this be I ask myself???? I understand during times of infection my dad may not want food or fluid but surely that's why the have logs of food and fluid intake to monitor this? If he had not been having adequate intake of fluids should further advise not been sought??

Am I being rationale in my thinking, using the word neglect? (Not for the first time)

FYI I have been working away allot during the past couple of months so to some degree I feel guilty for not giving my father the time and support he deserves but this is not about making me feel better it's about every resident in that home (lots who don't seem to get visitors) and hoping there basic care needs are being met.

Maybe I am missing setting here??

Although this is my first post here please note I have visited the site regularly and lots of your experiences and advise have helped me through extremely tough times.

Any words of advise will be greatly appreciated.

Thanks
Richie3210

 

[jaymor]

Hi Richie,

Sorry your Father is unwell but he is now going to get the right treatment and hopefully he will soon be feeling a lot better.

Have you taken a look at your Father's daily records? My husband's are available for me to look at at any time and they are completed every hour. I know from the book and because I am there often that he is given a drink every hour. I think this is too often as most of us would not want a drink every hour but they don't have to drink it. If the drink is not taken then that is noted. Each time a drink has been finished the capacity is added so there is always an up to date measurement of liquid consumed as the day goes on.

If they do not keep a very accurate record ask them to do so as your Father has become dehydrated without anyone noticing.
They have a duty if care and they must know how much liquid is required daily to make sure dehydration does not occur.

I hope you can get this sorted for your Father.

Jay

 

[juniepoonie]

that's awful Richie thank goodness your on the ball with the home . as you say some residents don't have another voice do they. it does make me wonder! I wish all the homes were of the same standed but there just not are they. keep up the good work in getting the right treatment for your dad an others along the way. juniepoonie

 

[piedwarbler]

The hospital May comment to the home on discharge if they feel that dehydration was avoidable.
My mum was in four care homes before her death. I never managed to get her anywhere where I was happy with the amount she drank. She was invariably thirsty whenever I visited. Drinks were ignored as she could not recognise them due to dementia. I do think it's a huge issue. Carers have ten minutes to feed if you're lucky so if you can only drink slowly then clearly you are going to be left alone with a cup of drink before you've had chance to drink to the point of satiety.
I think you should always trust your instincts. They won't often be far wrong. As Mum's GP said to me, "having a vigilant relative is no bad thing."

 

[angelface]

Hi RItchie, this also seems a major problem at my aunt s ch. They keep a fluid chart IF they think it is needed, even then it seems most inaccurate.
I am constantly told the GP think s auntie is not dehydrated, but my observations say otherwise.
So difficult isnt it? The staff are really fedup with my nagging.

 

[jaymor]

I asked about fluids yesterday and my husband's nursing home say 1500 mls a day but they like to see the figure nearer to 1800.

Homes should document fluid intake all the time not just when they think they need to. How can anyone know what one persons fluid intake has been in any day in a busy care home.

Jay

 

[piedwarbler]

My mum often had around 500 - 600 Mls a day and quite often less.
I think it depends on how mobile you are how much fluid you need. Mum was bed bound and so doubtless she needed less to drink. She was very thirsty. X

 

[angelface]

My aunts old CH recorded what they offered her, not what she actually drank.
When I asked them to improve her intake, they just got cross with me. This is one of the many reasons I have just moved her to a different CH.
Glad to see the new one does things differently

 

[BLONDY]

Report your concerns to CQC how many other residents are not getting the care they deserve.

Sent from my LC0901D using Talking Point mobile app

 

[Auntiep]

I feel really guilty, Mum lives with us and I struggle to get her intake above 800 ml. She's always dehydrated but it's so hard

Sent from my GT-I9195 using Talking Point mobile app

 

[handyjack]

Richie, I work in a nursing home. A few years ago we had one resident literally collapse and taken into the local hospital. After tests, some junior doctor diagnosed that the resident was "dehydrated." A few days later (after supposedly being on an intravenous drip) the resident was returned to our care. Within one hour of return, the resident again collapsed and was rushed back to hospital. Guess what the diagnosis was ? (by yet another doctor) Yep the resident was again declared to be suffering from "dehydration". The hospital phoned our home saying they were unhappy about the situation, until the nurse read out the discharge notes from the hospital, filled in a few hours earlier. Turned out (eventually) the resident wasn't dehydrated at all, but suffering from some infection, which the hospital had missed the first time round and apparently were just about to miss the second time.
Getting fluids into our residents can be challenging at times though. With so much emphasis on "person centred care" these days, we're expected to respect their wishes , should they not want to drink or eat (notes are made however and constantly reviewed by nursing staff) Quite often it can take a lot of cajoling to get some residents to drink (and eat), but we always try our best.