1. Cornwall Hydration Project
focused on solving the long term problem of dehydration
in elderly & vulnerable care
Innovator and lead
Naomi Campbell RGN
Supported by NHS Innovations South West and Peninsula Community Health CIC
©2012 Naomi Campbell- Cornwall Hydration Project

2. ©2012 Naomi Campbell- Cornwall Hydration Project
Every day thousands of vulnerable elderly people are suffering with the effects of dehydration The associated costs to our NHS is estimated to be billions per annum
©2012 Naomi Campbell- Cornwall Hydration Project

3. All Parliamentary Hydration Forum
Cornwall Hydration Project: National Profile
All Parliamentary Hydration Forum
House of Lords

4. 2011 Naomi was commissioned by the
Nursing Times
Author Naomi Campbell 2011
©2012 Naomi Campbell RGN Cornwall Hydration Project

5. Dehydration in elderly care is avoidable...
How?
By simply encouraging and helping our vulnerable elderly population to drink adequate daily fluids
Solving this avoidable problem must be made a healthcare priority
The following slides provide an over view of the scale of the problem
©2012 Naomi Campbell- Cornwall Hydration Project

6. ©2011 Naomi Campbell- Cornwall Hydration Project-VIP
Helping a patient to drink... Very little has changed over the past 50 years!
Helping a frail elderly or vulnerable person to drink... Is NOT always a simple task... Above all it needs ‘time, kindness & patience’
©2011 Naomi Campbell- Cornwall Hydration Project-VIP

7. What do I mean by the term avoidable dehydration?
‘Where dehydration could have been prevented or treated by simply giving the patient enough to drink according to individual needs’
Universal agreement suggests a minimum of 1500mls per day is needed to prevent the onset of dehydration
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'

8. ©2012 Naomi Campbell- Cornwall Hydration Project
A reminder... This study from 1984 highlights that dehydration is a long term global problem in health care
2012 – dehydration remains a persistent problem & is escalating along with the aging population
©2012 Naomi Campbell- Cornwall Hydration Project

9. 2005 Despite many initiatives – why does dehydration remain a problem?
HOW
Can we support our ‘carers’ To
Solve this problem
WHY
Is it still a
Problem ?
How much longer must elderly people suffer
2005
©2012 Naomi Campbell- Cornwall Hydration Project

10. Cornwall Hydration Project
Provides a global ‘Birds Eye’ view
of the problem of dehydration...
The UK
is not alone –
Dehydration of Vulnerable Infirm Patients
is an International problem
USA & Australia have led nursing research
But
More research is desperately needed..
Europe is working together through
the
Cornwall Hydration Project - Naomi Campbell © 2012

11. Ageing Population (millions)
% UK population
This shows Government population projections from 2010 to Key impacts are that those who have the largest costs to the NHS are set to increase significantly. Population of :
Over age 60s will increase by half.
Over 75s will increase by 80%
Over 85s will increase to 2.5 x the 2010 total from 1.4m to 3.5m.
REF:
©2012 Naomi Campbell- Cornwall Hydration Project

12. more will require help to drink & eat
1000’s
more will require help to drink & eat
©2012 Naomi Campbell- Cornwall Hydration Project

13. We know the risk factors
Tdddd
Dependent on Carers to safely hold a cup
Reduced thirst response
Reduced mobility
↑ Demands on Carers
“ the Nurses are so busy”
↑ Need for toilet ↑ Disturbance and pain
Drinks out of reach
Too heavy to handle
Loss of Dignity
Dementia / Diuretics / Age / Disabilities
COPD
Swallowing problems
Cornwall Hydration Project - Naomi Campbell © 2012

14. Dehydration
why is it so complex?
No gold standard to measure or define dehydration
Normal Age related changes can mimic dehydration symptoms
No absolute agreement on how much individuals should drink
Blood & urine tests can not reliably detect early stages of dehydration
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'

15. Universal agreement
Dehydration can be prevented or treated by having enough to drink
(approx 1600mls )
We already know the risk factors...
But still the problem is increasing!
Simple well know symptoms provide a good indicator of hydration
e.g. Urine colour / dry mouth
Monitoring how much people are drinking is vital
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'

16. But we can safely say it is costing the NHS billions!
What is the actual cost of dehydration?
Nobody really knows as dehydration is often not cited as a primary cause
But we can safely say it is costing the NHS billions!
©2012 Naomi Campbell- Cornwall Hydration Project

17. Early signs of dehydration
Helping a person to drink – saves lives and saves money
Early signs of dehydration
Confusion / delirium
Pain & frequency
Increased nursing care
High temp / malaise
Anti-psychotic medications
GP - Antibiotics
Acute Admission
Urine Infection
Enemas
Indignity
Laxatives
Loss appetite
Constipation
Acute Admission
Malnutrition
Loss appetite
Loss of confidence
Loss of independence
PRESSURE ULCERS
Reduced mobility
Injury
Acute Admission
Dizziness & Falls
Fractures
999
A&E
Admission
Surgery
Rehab
Discharge
IV fluids Antibiotics
Higher
skill mix
Medical expertise
Multiple medications
Length of stay
& Costs
Risk Hospital Acquired
Infections
Morbidity &
Mortality
© Cornwall Hydration Project – Naomi Campbell RGN 2012

18. Dehydration is directly linked to
Malnutrition
Falls
Pressure Ulcers
Urine Infections
Constipation
Increased length of stay
Increased morbidity
£7.3 billion per annum
£0.15 billion
£2.1 billion
£1.24 billion
£0.6 billion
£ unknown
Ref:NHS III 2009
©2012 Naomi Campbell- Cornwall Hydration Project

19. ©2012 Naomi Campbell- Cornwall Hydration Project
What can Cornwall Hydration Project offer to solve this long standing problem?
Raise awareness about the daily challenges of ‘Helping an elderly person to drink enough’
A review of current practice
Highlight the weakness and gaps in the current systems and processes that supports hydration care
Developing innovative new measures to improve assessment / monitoring / equipment / staff training & health promotion
©2012 Naomi Campbell- Cornwall Hydration Project