Patients admitted to hospital from care homes are commonly dehydrated on admission and consequently are at significantly greater risk of in-hospital mortality, according to a major UK study.
Although known to be a problem anecdotally, the new study has identified the risk of dehydration from care home patients to be five to 10 times that of patients living in their own home.
Researchers reviewed over 20,000 patients aged 65 years and over admitted to a London hospital for the first time between January 2011 and December 2013.
They found 1% of patients admitted from their own home were found to have high sodium levels – caused by dehydration – while the figure for patients admitted from care homes was 12%.
After adjustment for a number of possible explanatory factors, including age and dementia, the risk of high sodium levels was still over five times higher for those admitted from care homes.
“Clearly this level of dehydration is a problem. Further research is needed to understand why it is occurring”
The study was carried out by researchers from Barnet and Chase Farm Hospitals NHS Trust – taken over by the Royal Free London NHS Foundation Trust in July 2014 – Oxford University and the London School of Hygiene and Tropical Medicine.
Lead author Dr Anthony Wolff, from the Royal Free, said: “Our study shows that too many patients admitted to hospital from a substantial number of care homes are dehydrated, leading to unnecessary loss of life.
“High sodium levels in care home residents should raise questions about adequate support for drinking,” he said.
Co-author Professor David Stuckler, from Oxford University, said that “clearly” the level of dehydration identified in the study was “a problem”.
He added: “Are care home residents choosing to drink less than they should? Or, as has been speculated, are care home staff not offering enough water to reduce incontinence and the amount of assistance their residents require?”
The findings were published today in the Journal of the Royal Society of Medicine.