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Should We be Concerned that Nursing Home Staff are Ignoring our Elderly Loved one’s Possible Dehydration?

Absolutely. Dehydration for any individual can result in serious medical complications down the road, but in an elderly person, the lack of proper hydration can be particularly dangerous. It is the responsibility of nursing home staff to ensure that all residents are supplied with a sufficient, and conveniently located, supply of fresh water to avoid dehydration. Similarly, for bedbound residents in Maryland elder care facilities, the staff members should monitor the relative hydration of residents and act accordingly if any signs of dehydration begin to appear, especially in the hotter summer months.

While nursing home abuse is referred to as “the willful infliction of injury… with resulting physical harm, pain or mental anguish,” the act of neglect is a much more subtle one, although the results can be just as serious or worse than that arising from outright abuse. When neglect occurs, it differs from abuse in that it arises out of indifference or inaction on the part of a nursing home or its staff.

The appropriate yardstick for such negligence would be what is known in legal circles as the “reasonable caregiver standard.” This standard asks if the suspected negligent party (the organization as a whole or an individual staff member) acted in the same way that a “reasonable caregiver” would act given the same circumstances. When it comes to a resident’s lack of hydration, this is a serious situation that needs constant monitoring by nursing home employees.

Preventing Elderly Dehydration

It is important that nursing home professionals watch for signs of dehydration in the individuals under their care. While the effects of certain medical conditions show up quite clearly, other illnesses can present themselves in much more subtle ways. Depending on its severity, dehydration can have quite a large effect on daily living, yet the signs leading to a serious case of elderly dehydration can initially go undetected until an individual begins to suffer unnecessarily. There is no good reason why this should happen if the nursing home staff is properly trained to recognize the initially subtle effects of dehydration.

Technically, dehydration takes place when an individual loses more water — through the act of perspiration, urination, vomiting or other processes — than he or she takes in via drinking, eating or by IV fluid replenishment. Maintaining an appropriate level of hydration allows a person’s body to properly regulate temperature, maintain blood pressure and eliminate bodily waste.

However, in cases of severe dehydration, deleterious medical conditions can begin to crop up, including mental confusion, physical weakness, urinary tract infections (UTIs), development of pneumonia, appearance of bedsores in bed-bound nursing home residents, or even death. For the average person, surviving more than four days without any water becomes less and less of a possibility; for the elderly, this timeframe is typically much shorter.

What are the Causes for Elderly Dehydration?

At Lebowitz & Mzhen, LLC, we understand how difficult it can be to read the subtle physical and mental changes that can affect an elderly parent in a nursing home environment, much less be able to attribute any one symptom to possible nursing home abuse or neglect on the part of an elder care facility’s staff. Here are a few of the common causes of dehydration in an elderly family member:


These days it is hardly uncommon for elderly individuals to be on a daily regimen of several different prescription medications. It is therefore important to understand which, if any, of those drugs may be diuretic (urine-producing) in nature, and which ones may cause the person to perspire more than usual. In the case of nursing home residents, the physicians and staff should be aware of the effects of any drugs being used by a resident, as well as how to counteract the possible negative effects that those medications may have on that individual’s state of hydration.

Decreased Thirst

It is a known fact that as we age our sense of being thirsty becomes less and less acute. Furthermore, elderly patients and older nursing home residents may eschew getting up for a drink of water due to the fear that they may fall, or simply because rising from a chair or getting out of bed takes so much additional effort. As a result, residents of nursing homes and other senior living facilities often rely on caregivers for their hydration needs. However, if members of the nursing home staff do not have the proper training, they may not know when a resident is suffering the ill effects of dehydration until it becomes so serious that it is now a potentially life-threatening situation.

Reduced Kidney Function

In older individuals, kidney function begins to decline usually beginning around the age of 50, but becomes much more acute once a person has reached 70. The net effect of this decrease in kidney function is that the body is less able to conserve fluid, which only serves to exacerbate a situation where an individual is already suffering from some level of dehydration.

Effects of Illness

Any time a person is fighting a cold, flu or other illness — and which involves vomiting and/or bouts of diarrhea — the patient is prone to losing fluids more rapidly than when he or she is feeling well and physically healthy. Loss of fluids due to illness can make anyone feel dehydrated, but in the case of elderly patients, that dehydration can come on much quicker and result in much more serious and potentially deadly side effects.

At Lebowitz & Mzhen, LLC, we understand the importance of proper nursing home care. If the level of proper care decreases to the point of becoming a threat to the health and wellbeing of your elderly family member, the nursing home and its employees must be held accountable. Our seasoned personal injury attorneys are well equipped to assist families of elderly individuals who have received sub-standard care or who have been otherwise mistreated in a Maryland nursing facility.

Recognizing early on that a family member may be suffering from a lack of hydration could be your loved one’s best defense against a serious health issue in situations where members of the nursing home staff are less attentive than they should be. Below are some key indicators of dehydration:

  • Mental confusion
  • Trouble walking
  • Sunken eyes
  • Inability to perspire or produce tears
  • Increased or rapid heart rate
  • Drop in blood pressure
  • Dizziness or headache
  • Dry mouth
  • Infrequent urination
  • Reduced urine output
  • Dark urine
  • Constipation

Should you suspect that your elderly family member is suffering from dehydration, pinch and pull up the skin on the back of the person’s hand (checking for reduced “skin turgor”) for a few seconds, then release. If the person’s skin does not return to normal almost immediately, this is a sign that he or she is dehydrated.

If you believe that your loved one has suffered serious health effects from poor nursing home care, or if he or she died as a result of possible nursing home neglect or abuse, the lawyers at Lebowitz & Mzhen, LLC are ready and willing to help. Please do not hesitate to contact our law offices to set up a free, no-obligation initial consultation so that you can better understand your rights under the laws of the State of Maryland.

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