Systematic Hydration Rounds Versus a Socially Assistive Robot to Promote Fluid Intake in Institutionalized Older...

Background: Several strategies have been proposed to promote hydration among institutionalized older adults, including systematic hydration rounds and, more recently, the use of Socially Assistive Robots (SAR). However, their implementation in nursing homes remains limited. Objective: To compare changes in fluid intake over a one-month period among residents exposed to two hydration-promotion strategies and to identify baseline characteristics associated with fluid intake. Methods: A quasi-experimental study was conducted in a nursing home. Residents were assigned to either a systematic hydration rounds intervention with manual recording or a SAR-supported multicomponent educational intervention including reminders, positive reinforcement, and digital intake monitoring. Fluid intake was monitored for one month and analyzed using adjusted mixed-effects linear regression models. Results: Residents in the systematic hydration rounds group showed higher fluid intake throughout follow-up. In the longitudinal analysis, assignment to the SAR-supported group was independently associated with lower fluid intake during follow-up (β = -354.24 mL/day; p < 0.001), after adjustment for baseline fluid intake and functional dependence. No significant differences were observed in intake trajectories between strategies. Dysphagia was independently associated with lower fluid intake, whereas diabetes was associated with higher fluid intake. Conclusions: Residents assigned to the systematic hydration rounds group showed higher fluid intake during follow-up. Dysphagia was associated with lower fluid intake, highlighting the need to adapt hydration-promotion strategies to residents' swallowing-related needs. Although the SAR-supported intervention was not associated with higher fluid intake, the findings suggest that technological tools for hydration promotion and monitoring require adequate integration into routine clinical practice.