1. Hydration for the elderly Dr Rekha Elaswarapu Associate Fellow International Longevity Centre - UK 28th October 2015 Natural Hydration Council

2. Why hydration? Water is an essential ingredient for living Lack of hydration can have a serious impact on one’s health Dehydration is a great concern for some groups of people e.g. Elderly or those with multiple health conditions Older people tend to reduce their intake of fluids as they grow older Care providers have a vital role to play in preventing dehydration

3. Recommended intake of fluids for elderly The estimation of water requirement is highly variable and quite complex. In 2010 European Food Safety Authority set a reference value for total fluid intake (water provided from beverages and foods) of 2.5L for elderly men and 2L for elderly women (minimum 8 glasses a day) Some research into intake of fluids has identified that older people do not drink as much as they should 85 yrs+ are most at risk of dehydration

4. Impact of dehydration Pressure ulcers Dizziness and confusion increased recovery times from surgery frequent hospital admissions longer hospital stays increased use of antibiotics with side effects Avoidable conditions leading to higher risk of mortality Urinary tract infections (UTIs)

5. Barriers to hydration Lack of choice Clinical needs/cultural beliefs not met Access to water or fluids Lack of support with eating/drinking Food & water intake not monitored Lack of support with toileting Clinical barriers Thirst reduction Appetite reduction Swallowing difficulties Bladder problems Water loss due to certain illnesses Medications Systemic barriers

6. Improving hydration – the challenges  Lack of general awareness about fluid intake  Lack of robust screening tools  Inadequate care planning and monitoring regarding hydration  Lack of focus on hydration in training  Lack of adequate focus on hydration in regulation  Gaps in research and high quality evidence into hydration and good practice guidance

7. The Hydration Action Plan 1.To raise awareness about the importance of hydration and prevention of dehydration 2.To ensure that up to date good practice guidance is available across all sectors 3.To promote screening for hydration for all people using health and social care services with special focus on people in vulnerable circumstances 4.To incorporate in the training for front line managers and care providers the significance of hydration in care provision 5.To ensure inclusion of hydration in inspections and regulation through essential standards of quality and safety 6.To develop robust and high quality evidence by encouraging research into hydration in health and social care

8. Suitable resources Human hydration http://www.naturalhydrationcouncil.org.uk/wp- content/uploads/2012/11/NHC-Essential-Guide-Hydration-FINAL.pdfhttp://www.naturalhydrationcouncil.org.uk/wp- content/uploads/2012/11/NHC-Essential-Guide-Hydration-FINAL.pdf Hydration in elderly http://bit.ly/1NxEg9Fhttp://bit.ly/1NxEg9F Water for healthy ageing http://bit.ly/1QboA9Mhttp://bit.ly/1QboA9M

10. Thank you for listening Dr Rekha Elaswarapu Associate Fellow, ILC-UK Rekha_elaswarapu@yahoo.co.uk @relaswar Natural Hydration Council