Dehydration is the excessive loss of water by an individual which in turn reciprocates in the disruption of the normal bodily functions. This improper functioning of the body is mainly caused by the fact that the human body is in a constant state of losing fluids and it is always required that the lost water be replaced, however if not replaced, then complications may arise. The elderly in the nursing homes tend to be victims of dehydration mainly due various reasons such as being unable to speak out when they need to be given fluids and further inadequate supervision from the personnel in the nursing homes. Various researched have been carried out with the aim of educating the public on how to recognize dehydration amongst the patients in the nursing homes and further how to treat dehydration.
In the research that was carried out by Arcand (2015) which was aimed at demystifying the various questions that were always associated with dehydration, poor nutritional intake and the advance dementia. It was realised that the use of feeding tubes was not recommended for the patients who were at the end-stage of dementia and rather hand feeding was considered to be better(Arcand, 2015). The research further provided for the various symptoms that were able to help one identify dementia. This research is valuable in the study since it helps give the various treatments of dehydration and further provides for the change in treatment for the betterment of the patients in the homes.
In 2015, a research was carried out by Bunn (2015) with the objective of assessing the role of interventions and factors that surround the patient which in turn they said would lead to an increase in fluid intake amongst the patients in the nursing homes and this they opined would lead to a decrease in the cases of dehydration in the homes. From this study, it was realised that the intervention truly reduced the number of dehydration cases and they provided for various recommendations to tackle this issue of dehydration such as always having beverages, increasing staff awareness and further increasing the level of care by the nurses in the homes to contribute to the reduce in the instances of dehydration within the homes. However, the research was said to be occasioned by bias due to it having a less a selection and attrition bias this is caused by the lack of valid outcome measures of fluid intake and dehydration assessment. This research is important in the study since it is able to show the various treatment options that are able to be used to cure dehydration(Bunn, 2015).
In theBegum Monirun (2010) research was carried out with the aim of showing the prevalence of dehydration amongst the elderly in the nursing homes. The research results showed that dehydration among the institutionalized elderly in the community is of concern due to it being a prevailing issue that has to be addressed. Further, the research showed that tackling dehydration is a costly venture to both the affected persons and the institutions themselves(Monirum, 2010). It further enlisted the various effects that dehydration could cause the victims and these were cases of disorientation and acute confusion. The research further provided for the various methods that would be used for one to be able to detect dehydration among the patients. From the research it was realised that it was necessary for individuals to be able to detect and have in place various measures to tackle dehydration among them patients in the institutions. However, this research had a downside side it was commented not to be up to task and needed further research to be carried out(Monirum, 2010.
In the research that was carried out by Gaspar (2011) was aimed at showing that providing adequate dehydration was a problematic venture for the institutions and the people tasked with that duty (Gasper. 2011). This research is vital for our research since it provides the various statistics and evaluation and the measures that were used in testing. It further provides for the fact that when coming up with the measures, they must be measures that are cost effective and are able to help combat dehydration(Gasper, 2011)
In the research that was carried out by Clave (2012) was one which was aimed at proving that Oropharyngeal dysphagia (OD) was a condition that was common among the elderly in the community. The research was able to prove that OD was a prevailing disease in among the patients in the nursing institutions to a staggering high of out of every 2 patients, one suffered from it(Rofes, 2012). It further causes the victims to have impaired judgement and dehydrated among other effects on the victims. The research further recommended that OD can be recognized via the screening of the victims when they start showing the stated signs and further it can be checked by the nurses having in place measures that would help enhance the viscosity of the bolus to in turn help in preventing it from affecting the victims(Rofes, 2012)..
In the research that was carried out by Garcia (2001), was aimed at showing the various troubles that the elderly in the society experience pertaining to them being hydrated(Garcia, 2001). This case was able to show that a large number of the elderly always are dehydrated and in turn it has gone ahead to give statistics of how many of the adults are not dehydrated as required and further shown that they take a minimal of 1300Ml/day. This is important for the study as it has provided for the changes that will lead to the changes that are required(Garcia, 2001)
The research that was carried out by Dr Lee (2015) was one which was aimed at assessing the best osmolality equation which would be able to predict the Serum to plasma osmolality which they though would help in the routine blood test results via the screening of the dehydration levels amongst the elderly in the nursing homes. From the research it was realised that 19% of patients from each of the cohorts were dehydrated. From the research it was decided that the best equation in this matter was: osmolality=1.86×(Na++ K+)+1.15×glucose+urea+14 which was to be used to detect the levels in the patients who are 65 years and above. However, the equation was said not to be substantive since it requires a lot of factors to be considered and this in turn encourages the researchers to continue using the best formula from the pathology laboratories. This is important in the research as it shows the various ways that an individual is able to identify the traits of dehydration in the nursing homes
The research that was carried out by Kayser-Jones (199) was one which was aimed at looking into the factors that contributed to the fluid intake amongst the patients who were not feeding as required. The research was able to show that a huge number of the patients were not taking the fluids as required and 39 out of the 40 residents consumed less than 1500ml daily. The research further stipulated that they didn’t take the fluids as expected due to various reasons which were either due to the laxity of the nurses and the institutions or at times the language barriers and further the lack of vital functioning, like being able to feel pain and other functional impairments. However, the results were said not to be as required since more than half of the patients had other illnesses that may have been factors that may have further led to the dehydration. The research proposed that the issue of ensuring that the patients receive liquids each and every time that it was required and further, increasing the nurse to patient ration.
The research carried out by David Geffen (2001) was aimed at showing that a huge number of the patients in the nursing institutions were said to be victims of dehydration. The research findings were able to prove that the patients in the nursing homes receive less than required amounts (1500ml/ day) of fluid intake that would enable them combat dehydration. This research further went a step ahead to show that the main cause if dehydration among the patients was caused mainly by inadequate care by the nurses in the homes. This was further attributed to the fact that the nurse-patient ratio was nit favourable for each and every patient to be given the required care(Geffen, 2001).
In the research that was carried out by Marshall (2016) was carried out with the aim of exploring and describing retrospectively, the occurrence and relationship of variables that in most instances precede hospitalizations for malnutrition and dehydration among the patients suffering from dementia. It then stipulated that dehydration, and malnutrition is in most cases experienced by patients with dementia and in some instances may cause the patient to be hospitalized and deterioration in his or her health (Marshall, 2016). The research however was not regarded to be substantive due to the fact that the Data the 44 patientsreceived from the Michigan home care agency didn’t in turn provide the various indicators that may be used by the victims to see who may be affected by Dementia. Due to this, the researchers concluded that the individuals tasked with the duty of caring for the patients must put in place measures that lower the risk of the illness occurring and further educating them on how to prevent the occurrence of the disease.
In the research that was conducted by Mario Siervo (2014) was aimed at showing the relationship of the measured osmolality and the serum osmolality in the elderly in the society. The results were able to show that up to 46% of the society are always dehydrated and a further 18% of the participants with diabetes were realised to be dehydrated. The various equations were put in play and it was decided that the equation osmolarity = 1.86 × (Na++ K+) + 1.15 × glucose + urea +14; all in mmol/L wa able to predict osmolality regardless of the individual being diabetic or dehydrated (Sievero, 2014). The findings from the research were able to show that they were reasonable in nature. It was discovered that the equation was able to be used to show the osmolality levels in the frail older individuals and would further be used to estimate the hydration status in the studies of the population.
In the research that was carried out by Studdert (2011) was one which was aimed at comparing the number of cases that were being brought in the courts against the various nursing homes. The researchers compared the negligence and malpractice cases that were brought against the high-quality health care centres against the number against the high quality centres. It was realised that a huge number of cases were brought against the low-performing centres and from the findings it was clear that the level of service delivery in the high-quality centres was higher hence it was safer for the elderly to go to the high quality nursing homes.
The research that was carried out by Vivanti (2010) was one which was aimed at developing a clinically practical method to identify dehydration amongst the older patients in the nursing institutions. It further proved that dehydration is associated with increased in morbidity and mortality. Further it was realised that advancedage and dehydration were directly proportional. Various variables were tested and it showed that tongue-dryness was the most associated with dehydration. However, the results were not substantive and further investigations were required to prove the theory.
In the Anthony Wolf (2015) study, this was aimed at evaluating the associating of hypernatremia with the in-hospital mortality. It was realised that the patients who were admitted from home tended to be more affected by hypernatremia than their counterparts in the nursing homes. It was further decided that patients who were admitted to hospitals from the nursing homes were n most cases dehydrated and had a greater risk of in-hospital mortality due to them always being dehydrated.
In the Wang (2011) research which was aimed at investigating the key factors related to fluid intake and dehydration. It was realised that 45% of the subjects had a fluid intake less than the prescribed amount. Further it was realised that the subjects mostly the females in the society had a problem when it came to fluid intake and hence it was important that their fluid intake had to be adjusted accordingly to meet the prescribed levels.
References
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