Nursing practice and oral fluid intake of older people with dementia

This paper describes the findings of a descriptive study about what nurses do to ensure that older people with dementia have adequate hydration.

Frail nursing home residents, particularly those who cannot accurately communicate their thirst as a result of Alzheimer's disease and who depend on nursing staff for their fluid intake, are at risk of dehydration. While the interventions that promote nutrition in older people with dementia are documented, the specific interventions for improving oral hydration in older people with dementia remain poorly studied and understood.

Observational study.

Ten care workers and seven residents were observed for the types of behavioural nursing interventions and assistance provided to residents when promoting oral fluid intake. Observational data were compared with resident-care plans to determine whether what was carried out by care workers was consistent with what was being documented.

Care workers provided a wide variety of behavioural interventions to the residents when promoting oral fluid intake. The resident-care plans did not sufficiently represent the specific interventions implemented by care workers.

A more rigorous approach is required in defining the specific behavioural interactions practised by care workers, which promote oral fluid intake in older people with dementia. Nurses determined the content of care documented in care plans, yet they were not the predominant implementers of that care. Care plans need to be accurate in terms of the specific nursing actions that respond to the level of assistance required by the resident, both behaviourally and physically.

Sound knowledge and reflective practices should be implemented by care workers of the nursing interventions that promote adequate oral fluid intake. Care plans should serve a dual purpose and facilitate communication between staff members and provide sufficient flexibility to allow for the contribution of novel ways in which to promote oral fluid intake while also being educative.