media/10691/NISW Scale of dehydration October 2012

Report
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
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
Cornwall Hydration Project:
National Profile 2010 -2012
All Parliamentary
Hydration Forum
House of Lords
2011
Naomi was
commissioned by the
Nursing Times
Author Naomi Campbell 2011
©2012 Naomi Campbell RGN Cornwall Hydration Project
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
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
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'
©2012 Naomi Campbell- Cornwall
Hydration Project
Despite many
initiatives – why
does dehydration
remain a problem?
WHY
Is it still a
Problem ?
HOW
Can we support our
‘carers’
To
Solve this problem
How much
longer must
elderly
people suffer
©2012 Naomi Campbell- Cornwall
Hydration Project
The UK
USA & Australia have
led nursing research
is not alone –
But
More research is
desperately needed..
Dehydration of Vulnerable
Infirm Patients
is an International problem
Cornwall Hydration Project - Naomi
Campbell © 2012
Europe is working
together through
the
Ageing Population (millions)
2035
12.0
2025
5.4
10.9
2010
9.2
0.0
5.0
5.0
3.5
Age
Years
3.5
60-74
75-85
85+
2.3
1.4
10.0
15.0
% UK population
20.0
25.0
This shows Government population projections from 2010 to
2035. 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: http://www.statistics.gov.uk/hub/population/ageing/older-people
©2012 Naomi Campbell- Cornwall
Hydration Project
1000’s
more will
require help
to drink & eat
©2012 Naomi Campbell- Cornwall
Hydration Project
We know the risk factors
Dependent on Carers to safely hold a cup
Reduced thirst response
Reduced mobility
•Tdddd
↑ 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
Cornwallproblems
Hydration Project - Naomi
Swallowing
Campbell © 2012
No gold standard to
measure or define
dehydration
Normal Age
related changes
can mimic
dehydration
symptoms
Dehydration
why is it
so
complex?
No absolute agreement
on how much individuals
should drink
© 2012 Naomi Campbell 'Cornwall
Hydration Innovation Project'
Blood & urine
tests can not
reliably detect
early stages of
dehydration
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!
Universal
agreement
Simple well know
symptoms provide a good
indicator of hydration
e.g. Urine colour / dry
mouth
© 2012 Naomi Campbell 'Cornwall
Hydration Innovation Project'
Monitoring how
much people are
drinking is vital
Nobody really
knows as
dehydration is
often not cited
as a primary
cause
What is the
actual cost of
dehydration?
But we can safely say it is
costing the NHS billions!
©2012 Naomi Campbell- Cornwall
Hydration Project
Helping a person to drink – saves lives and saves money
Early signs of
dehydration
Acute
Admission
Urine Infection
Constipation
Loss appetite
Acute
Admission
Malnutrition
Acute
Admission
Dizziness & Falls
Fractures
999
A&E
IV fluids
Antibiotics
Length of stay
& Costs
Admission
Higher
skill mix
Surgery
Medical
expertise
Risk Hospital Acquired
Infections
© Cornwall Hydration Project – Naomi Campbell RGN 2012
Rehab
Discharge
Multiple
medications
Morbidity &
Mortality
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
£ unknown
Ref:NHS III 2009
©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

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