Hydration practices in residential and nursing care homes for older people

Aim: To scope and explore hydration practices in care homes. Background: Older residents do not regularly consume adequate fluids to support health. Achieving this is difficult with residents who have coexisting health, sensory and functional problems, as well as challenging hydration habits. Design: This project used a sequential exploratory mixed method design to scope and explore existing hydration practices. Methods: Data were collected via two stages. First was a survey of hydration practices. Twenty-nine responses were received from 81 care homes (response rate: 35.8%). Second was the exploration of practitioners' experiences and perceptions of hydration practice via semi-structured interviews (54 staff: 43 interviews). Descriptive statistics summarised the survey findings. Open coding and thematic analysis were applied to the qualitative data, and details of the methods are reported in adherence to COREQ criteria. Results: It is important to provide hydration support in addition to regularly offering drinks to residents. Hydration practices include the following: use of social interaction to encourage drinking; verbal and nonverbal prompts to drink; giving fluids with routine practices and social activities; providing drinks-related activity, use of aids and equipment to support drinking; and creating a drink-friendly environment. Practices are implemented in care homes; however, no one care home implements all these hydration strategies at any one time. Conclusions: Older care home residents need support and encouragement to drink adequate fluids which can be difficult to achieve with residents who have complex needs and challenging drinking habits. In addition to the routine offer of drinks, hydration support should be used to facilitate residents to drink sufficient amounts of fluid. Relevance to clinical practice: Staff working in care homes have an important role in assessing the hydration needs of residents and using multiple hydration practices to support residents to achieve their hydration requirements