Dehydration in Nursing Homes

Dehydration occurs when the body does not have enough fluids because more fluid is lost than taken in. Due to a variety of natural reasons, elderly patients are more likely to suffer from dehydration. This increased likelihood is sadly intensified in nursing home residents who may be victims of abuse and neglect.

Reviewed by Julie Rivers, MBA , Eldercare Advocate & Expert

Causes of Dehydration in the Elderly

Studies conducted by the American Geriatric Society show that inadequate staffing and lack of supervision are primary causes of nursing home dehydration.

As people age, their bodies become less able to hold a reserve of water and detect thirst. Illnesses such as Alzheimer’s disease and other dementias create an even bigger challenge.

Additionally, the elderly population, in general, has more problems with mobility, making getting up to get a drink a problem.

Other causes of nursing home dehydration include:

  • Colds or sore throats that make residents less likely to drink
  • Diarrhea and vomiting due to common illnesses
  • Excessive sweating due to certain cancer medications
  • Increased urination due to diuretics

Although some risks for dehydration in nursing homes are difficult to stay ahead of, the condition is preventable. If the potential for dehydration is recognized early on, medical complications can usually be avoided through intervention.

Signs of Dehydration in Nursing Homes

Early symptoms of dehydration can be difficult to notice, so it’s especially important to pay close attention to some of the common signs of dehydration that nursing homes often overlook.

Often overlooked signs of nursing home dehydration include:

  • Confusion
  • Dark-colored urine
  • Difficulty walking
  • Hypotension (low blood pressure)
  • Muscle cramps
  • Rapid heart rate

According to the Mayo Clinic, mild to moderate dehydration can usually be reversed by drinking fluids. However, late-stage dehydration requires immediate medical care.

Therefore, it’s very important to be able to recognize the signs of dehydration in nursing homes. If nursing home dehydration symptoms are not caught and result in serious complications, it is likely to be considered nursing home neglect under both federal and state laws.

Early Stages of Dehydration Symptoms

  • Constipation
  • Dry mouth or dry cough
  • Flushed skin
  • Headache
  • Loss of appetite with a possible craving for sugar
  • Low blood pressure (with high heart rate)
  • Swollen feet

Late Stages of Dehydration Symptoms

  • Confusion or slurred speech
  • Fainting
  • Hallucinating
  • Lack of sweating
  • Muscle twitching
  • Seizures
  • Temperature above 102 degrees

If you believe your loved one is suffering from nursing home dehydration, it is urgent to seek medical help. They may need intravenous fluid or other emergency care. Complications from severe dehydration can cause life-threatening conditions and even death.

Complications From Dehydration in the Elderly

Dehydration can cause a number of other serious complications, so it is vital that nursing home staff monitor and address symptoms of dehydration promptly.

Complications from nursing home dehydration include:

  • Coma
  • Kidney stones, kidney disease, or kidney failure
  • Seizures due to imbalanced electrolytes
  • Swelling of the brain
  • Urinary tract infections

One of the more serious complications that can be caused by nursing home dehydration is hypovolemic shock, which occurs when blood pressure and the amount of oxygen in the body drop. Hypovolemia can be life-threatening and may even lead to death.

Unfortunately, employees may not be properly trained to recognize the symptoms of dehydration in nursing homes.

Preventing Nursing Home Dehydration

It is very important for family members and loved ones to understand the seriousness of dehydration in nursing homes so they can be on the lookout for red flags.

Some ways to help protect loved ones from dehydration include:

  • Asking nursing home staff to encourage your loved one to drink liquids even if they don’t feel thirsty
  • Bringing sports drinks, oral rehydration solutions, and other fluid replacement options when you visit
  • Ensuring urine output is being monitored
  • Requesting extra fluids for your loved one
  • Talking to your loved one’s health care providers about their risk of dehydration so you know how much water intake they need
  • Visiting at different times of the day to make sure water is available
A quick check for possible nursing home dehydration is pulling up the skin on the back of your loved one’s hand. If the skin does not return back to normal right away, it could be a sign of dehydration.

Dehydration and Nursing Home Neglect

Although family and friends can play a key role in preventing nursing home dehydration, the bottom line is that nursing homes have an obligation to prevent dehydration. Failure to do so is a form of neglect.

In a study published by the National Institutes for Health (NIH), several factors contributed to dehydration in nursing homes. For example, the study found that fluid intake in residents was inconsistent, and even when fluids were given regularly, oftentimes it was not enough water.

“Using three established standards, we found that the fluid intake was inadequate for nearly all of the residents.”

Journal of American Geriatric Society

The study also found that some residents were unable to communicate their thirst either due to an inability to speak or not understanding English. The reality is that studies like this only prove what many people already suspect: Neglect in nursing homes is far too common.

Something as easily preventable as dehydration in nursing homes should not be an issue of this scale, causing hospitalizations and deaths. It’s critical for nursing homes to ensure adequate staffing and train their employees to know the signs and symptoms of dehydration.

Take Legal Action for Dehydration in Nursing Homes

The 1987 Nursing Home Reform Act declared that not assisting residents in getting adequate hydration is a form of neglect.

If your loved one suffered from complications due to dehydration, take legal action now. By filing a nursing home abuse or neglect lawsuit, you can get justice for your loved one’s needless suffering. More importantly, a successful nursing home lawsuit can get you the compensation needed to ensure your loved one receives higher quality care.

Nobody should have to experience dehydration in a nursing home. Get a free case review today to find out if you or your loved one is entitled to compensation.

You deserve justice. Get a free legal case review now.

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Reviewed by:
Julie Rivers, MBA
Fact Checked

Julie Rivers is an eldercare advocate with over 15 years of dedicated service to victims of nursing home abuse and neglect. Her journey in this field became deeply personal when she assumed the role of an unpaid caregiver during her mother’s battle with Alzheimer’s disease.

ReferencesView References
  1. Cleveland Clinic. (2021). Dehydration. Retrieved March 16, 2021 from

  2. Gaunt, A. (2020). Dehydration in the Elderly: Signs and Prevention. A Place for Mom. Retrieved March 15, 2021 from

  3. Kayser-Jones, J., Schell, E. S., Porter, C., Barbaccia, J. C., & Shaw, H. (1999). Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision. Journal of the American Geriatrics Society, 47(10), 1187–1194. Retrieved March 15, 2021 from

  4. Lehman, S. (2015). Nursing home patients more likely to be dehydrated. Reuters Health. Retrieved March 15, 2021 from

  5. Martindale. (2011). Dehydration, A Silent Killer of Nursing Home Residents. Retrieved March 15, 2021 from

  6. Mayo Clinic. (n.d.) Dehydration. Retrieved March 15, 2021 from