Hydration and Dehydration Prevention in Nursing Homes: Perspectives, Barriers, and Practices of Care Teams and Managers

TL;DR

This study explores how nursing home staff and managers identify and prevent dehydration in older adults, highlighting challenges and potential solutions.

Contribution

The study provides insights into the barriers and facilitators of hydration management in nursing homes from the perspectives of care teams and managers.

Findings

Participants identified limited training and lack of protocols as major barriers to hydration management.

Facilitators included hydration reminders, improved water accessibility, and institutional support.

Early detection and personalized strategies by nursing teams are crucial for effective hydration management.

Abstract

Background: Low-intake dehydration is frequent among institutionalised older adults and is associated with high morbidity–mortality and healthcare costs. Its prevention requires effective strategies and professional and institutional coordination. Objective: This study aims to explore the knowledge on the identification and prevention of dehydration, as well as the management of hydration by healthcare professionals and management in a nursing home. Methods: This exploratory qualitative study with a phenomenological approach convened two focus groups with 18 nurses and assistants alongside two semi-structured interviews with managers. The content analysis addressed five dimensions: knowledge; identification of dehydration; prevention of dehydration; barriers and facilitators; and actions proposed to improve hydration. Results: Participants recognised the importance of hydration but reported barriers including limited training, absence of specific protocols, and imprecise record systems. Facilitators included hydration reminders, improved accessibility to water, sensorial resources, promotion of independence, social activities, and institutional support for preventive strategies. Conclusions: These findings show that preventing and managing dehydration in nursing homes is complex and can be influenced by organisational and structural factors. The nursing team plays a central role in detecting dehydration early and implementing personalised strategies to promote fluid intake, while managerial support strengthens their effectiveness. Improving staff training, developing practical guidelines, and refining record systems may help address the identified barriers and enhance person-centred hydration management aligned with residents’ needs.