Dehydration in older adults, though easily avoidable, can have detrimental effects on health and wellbeing. Aquarate explains how its fluid monitoring smart cup can help mitigate this problem.
Dehydration is one of the simplest illnesses to avoid but still leads to thousands of avoidable deaths each year, especially among our vulnerable older generation.
Just a 1.5% drop in hydration levels is classed as ‘mild dehydration’ and causes unwanted side effects, with prolonged and more serious dehydration leading to life-threatening situations.
No matter what care setting you are involved in, it is vital that hydration levels are kept to an optimum to maintain bodily functions and ensure people are looked after.
Alleviating dehydration in domiciliary care
We all want our loved ones to stay in the comfort of their own homes and live independently for as long as possible, but as we age, bladder and kidney function deteriorates, and we usually need to go to the loo more often. Many medicines have a dehydrating effect and therefore require more fluid intake than normal, which is often forgotten. These factors, along with many older adults simply not feeling as thirsty as they used to, leads to a reduction in fluid consumed and therefore dehydration.
It can be very difficult to personally look after an older family member when life is so busy. But keeping them hydrated can avoid many unpleasant side effects, and illnesses, and should be simple but is often overlooked. Even if your family member has a community carer who visits a few times a day, hydration levels still are not often a priority.
As Rhianne Woodfine, occupational therapist for Hounslow and Richmond Community Healthcare NHS Trust explains: “Reminders can be set on alarms, or carers can prompt fluid intake when they visit, but it is difficult to monitor. Generally, patients do not have more than four care calls in a day which is often not enough to maintain hydration. A lot of the admissions involving older adults that we see in hospitals are due to dehydration or falls.
Being able to track and monitor fluid intake at home can reduce hospital admissions and injury from falls in the community. Family, carers and key workers could keep an eye on fluid levels and phone call the patient to remind them to drink if appropriate. Having access to an online portal would reduce stress on them, as they can have peace of mind that they are not dehydrated.”
Aquarate’s Hydracup is a simple smart cup that discreetly tracks fluid automatically. The data is sent to an application that carers can log into remotely and see exactly how much an individual has drunk. This allows you to act in real-time, nudging the person you are caring for to have another drink and you can see whether they do or not!
Our team will come and set everything up for you so all you need to do is simply swap out their current mug of choice with the Hydracup and you are good to go. With wobble, spill and pour detection, you will always know when they have spilt their drink or thrown it down the sink, so you get a real reflection of what they have actually drunk.
This is what some of our customers and users have to say:
89-year-old home user: “Living with various medical conditions, it is really important to make sure I drink plenty of water to keep hydrated. The Hydracup is a great solution: it is easy to drink from, feels comfortable to hold and lets me know exactly how much liquid I have consumed each day. A really great product!”
Wirral Council: “Aquarate providing this solution is very timely given the big push on dehydration across the sector and will allow us the opportunity to test cutting-edge healthcare technology. Preventing dehydration is a pressing concern as it can lead to unnecessary hospital admissions and functional decline for residents. We are looking forward to working closely with Aquarate as they provide this digital solution, whilst seeing the benefits for the user, the care provider, and Wirral Council.”
90-year-old home user’s daughter: “We now know with confidence how much my Dad is drinking each day and it is helping to keep him properly hydrated. He is alert and seems like his old self again.”
NRS Healthcare: “This is really good news, there is a pent-up demand for hydration monitoring products in Torbay and any development to further the Aquarate offering can only bring health benefits to those who are unable to manage their own liquid intake. The Aquarate offering differentiates between drinkers so that more accurate monitoring is possible.”
Hydracare for intermediate care
Intermediate care, or reablement, is vital for older patients leaving hospital who are not stable enough to go back to their homes just yet. It is an important middle ground and a much-needed step-down service. However, when leaving the hospital, it is estimated that 62% of older people who were admitted to the emergency dehydrated, were still dehydrated 48 hours after admission highlighting the lack of priority given to patient hydration in hospitals.
The average stay in intermediate care beds is 27 days in the UK with a daily cost to the NHS of £400-£600 per person, per day. Studies suggest that improved fluid monitoring and maintaining optimum hydration levels in intermediate care can decrease the length of stay significantly.
There are more than 14,000 intermediate care beds in England with capacity only sufficient to meet around half of the demand, increasing the waiting times for patients needing a bed.
Reducing the time patients stay in intermediate care could not only save the NHS millions in support costs but could notably reduce staff time for manually monitoring hydration levels. Manually filling out a paper-based fluid chart is both timely and inaccurate and with Aquarate’s data integrated straight into your care management system, you can see fluid data alongside other records.
As the healthcare market continues to battle to keep up with the increasing demand and new pressures from COVID-19, remote fluid intake monitoring has never been needed more.
Here is what some of our customers and users have to say:
Natalie Erickson, a nurse at Liverpool Royal Hospital: “We currently use paper charts for fluid balance monitoring. This means that staff have to ask the patients what they have had to drink and rely on the patient remembering what they have had to drink.
For those unable to report to staff what they have consumed, the system relies on staff being around when drinks are collected, which is not always possible. Intravenous fluid recording can vary, and output monitoring can prove difficult, particularly if the patient is mobile. These, amongst other issues, lead to discrepancies in the accuracy of fluid balance charts.”
Dr Mike Fisher, CCIO at Liverpool and Broadgreen University Hospitals Trust: “We are proud to be working with Aquarate. We are using twenty-first-century technology to solve a very old patient safety problem, employing sensor-enabled devices to monitor a patient’s fluid balance to improve the quality and safety of their care.”
Marie McCarthy, a nurse at Liverpool Royal Hospital: “Fluid balance plays a very important part in the patient assessment. It can influence treatment choices and decisions. The accuracy of the fluid balance charts is currently only as good as the person filling them in. External influences such as time constraints, busyness and staffing levels can all contribute to the accuracy, or otherwise, of the fluid balance charts currently in use. To have a digital system in place would help to improve the accuracy and eliminate some of the factors affecting the current process of manual completion.”
Stefano Bustini, ST5 doctor at Liverpool Royal Hospital: “The NHS is an organisation known for using legacy systems which are in many cases paper-based. It is also an organisation in which staffing levels can sometimes be limited and in which huge amounts of data need to be processed and analysed. New technology could greatly increase the accuracy and speed of these activities. Hydracare would reduce the time staff spend manually recording fluid balance data for patients, thus freeing them for other tasks. It would increase the accuracy of patient fluid balance data, which would contribute to increased patient safety.”
Hydracare for care homes
Although dehydration is an easily preventable condition, staff shortages and inadequate staff education can lead to dehydration-related morbidity, mortality, and impaired quality of life in institutional care settings such as hospitals, nursing homes and care homes. It is believed that 20% of older people living in UK care homes are dehydrated and at least two older patients a week die of hunger or thirst.
Dehydration has been highlighted as a common cause of admission to hospital in nursing home residents via UTIs, falls and fractures. UTIs and AKIs are often over-diagnosed and over-treated where an accurate way of monitoring hydration could often be the solution.
Being properly hydrated also improves skin conditions with fewer wounds and marks. Bowel movement is also greatly worsened by dehydration and constipation is a huge problem in care homes, especially for residents who take codeine for pain relief and other medication which makes constipation worse. Ensuring residents drink enough fluid reduces individuals’ dizziness and drowsiness and increases the cognitive function needed to see each person’s character.
Within care homes, manual fluid balance sheets are still used which are time-consuming and hard to keep accurate. On average, carers spend six minutes per day, per resident monitoring a resident’s fluid this way. This presents a huge potential saving in staff costs and would free up time for other caregiving tasks.
As well as cost savings and a reduction in hospital admissions from care homes, using Aquarate’s Hydracare system to track fluid consumption can also reduce medication needs drastically and provide vital data required by the CQC for proving the care home is meeting their residents’ hydration needs.
Here is what some of our customers and users have to say:
Gail Howard, manager of Lakeside Care Home: “At the moment, fluid monitoring is a very time consuming and manual process. Carers have to hang around and watch how much residents drink during the drink rounds and guess the volume of liquid drunk. Recording fluid intake this way is inaccurate and is easy to input false data onto the system.
Using the Hydracare system will eliminate this manual process and time-consuming task. We want to focus on spending quality time with our residents, rather than watching what they do! My staff will be motivated by this new tool, knowing that they are able to look after the residents the best they can will excite them and will give them time to do other caregiving tasks.
Being properly hydrated should also improve residents’ cognition and hopefully, they will be more likely to get involved with activities and stimulating exercises. We are also really excited to give them more independence and allow them to drink their drinks at their own pace and not be worrying about having to constantly tell them to drink up so staff can add the information to our current system. Everyone is so busy so it will be great to free up the carers’ time.”
Omair Haider, managing director of Millennium Care: “We chose to partner with Aquarate because we recognise how fundamentally important good hydration is to the overall wellbeing of those in our care. Research has shown the risk that poor hydration can have on cognition, falls prevention and energy levels for those in later life. We are impressed with the seamless integration of the Hydracup with real-time data and technology that allows us to monitor, see trends and analyse data for more responsive care. All of this has been developed in an easy-to-understand system. In addition to this, we believe that by removing the need for manual entry of fluid intake our care and clinical teams are able to focus on more meaningful engagement and less task-focused care for our residents.”
Get in touch
Aquarate is rolling out the Hydracare system to care homes across the country and is working with hospitals to ensure smooth integration of data straight into their chosen care management system. We are in discussion with over 150 councils to implement hydration monitoring into the community.
If you want to get involved and see how simply swapping to our cup can improve the lives of people that you care for, get in touch for a demo.
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This article is from issue 21 of Health Europa Quarterly. Click here to get your free subscription today.
