Is Dehydration in Nursing Homes Considered Negligence?

Dehydration in nursing homes is a common problem that can have serious consequences for residents. According to the Mayo Clinic, dehydration is a condition that occurs when a person does not have enough fluid in their body to function properly. It can be caused by a variety of factors, including illness, medication, and lack of access to fluids.

In nursing homes, dehydration is a particular concern because residents may have difficulty communicating their needs. Residents may be unable to access fluids on their own. In this blog post, we will explore the causes and consequences of dehydration in nursing homes. We will also discuss whether nursing homes can be held legally accountable when a resident becomes severely dehydrated.

Causes of Dehydration in Nursing Homes

There are several factors that can contribute to dehydration in nursing home residents. One of the most common is simply a lack of access to fluids. Residents may not be able to get to the water fountain or may not be offered fluids frequently enough by staff members. Additionally, some residents may have difficulty swallowing or may require assistance with drinking, which can make it more difficult for them to stay hydrated.

Another common cause of dehydration in nursing homes is medication. Many medications have diuretic effects, which means they increase urine output and can lead to dehydration. Additionally, some medications may cause residents to feel less thirsty or may interfere with the body’s ability to regulate fluid balance.

Illness is another factor that can contribute to dehydration in nursing home residents. Illnesses like diarrhea and vomiting can cause fluid loss, and residents may not be able to drink enough fluids to make up for this loss. Some illnesses may also interfere with the body’s ability to retain fluids, making dehydration more likely.

Consequences of Dehydration

Dehydration can have serious consequences for nursing home residents. In the short term, it can cause symptoms like headache, dizziness, and confusion. These symptoms can be particularly concerning for older adults, who may already be at risk for falls and other accidents.

In the long term, dehydration can lead to more serious health problems. Chronic dehydration can increase the risk of urinary tract infections, kidney stones, and other urinary problems. It can also lead to constipation, which can be uncomfortable and increase the risk of other complications.

Perhaps most concerning, dehydration can increase the risk of hospitalization and even death. According to the CDC, dehydration is a common cause of hospitalization among older adults, and it can be a contributing factor in many deaths.

Legal Implications of Dehydration in Nursing Homes

Nursing homes are required to abide by the “standard of care.” The standard of care for Alabama is defined as “that level of such reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice, ordinarily have and exercise in like cases.” Ala. Code Section 6-5-542. In almost every case involving medical negligence in Alabama, a person seeking to pursue a claim must have an expert witness that is willing to testify that there was a breach of the standard of care.

As you may have noticed, the legal definition of the standard of care is quite vague.  Therefore, most expert witnesses rely on federal regulations, industry-accepted practices, and medical literature to formulate their opinions about the standard of care applicable to a specific scenario. Many experts rely heavily on the federal regulations for guidance. In the nursing home context, the applicable federal regulations are 42 CFR 483, also known as the “OBRA regulations.”

There is a specific federal regulation related to dehydration. 42 CFR 483.25(g) states:

Based on a resident’s comprehensive assessment, the facility must ensure that a resident –

(1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident’s clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;

(2) Is offered sufficient fluid intake to maintain proper hydration and health; […]

As the regulations state, it is incumbent upon a nursing home to ensure that a resident receives sufficient fluid intake.  Whether an amount of fluid is sufficient will obviously be evaluated on a case-by-case basis.

In addition, nursing homes must be on the lookout for signs and symptoms of dehydration. The easiest signs to observe are less frequent urination, dark-colored urine, dizziness, and confusion. If a nursing home fails to observe signs of dehydration, fails to remedy the situation and death or significant injury results, then a nursing home may be financially liable for nursing home abuse or neglect.

At Siniard Law, we have hundred several cases where death resulted due to dehydration.  It is unfortunate that the elderly can pass away from something as basic as lack of water, but it occurs all too frequently.  If you have lost a loved one due to extreme dehydration in a nursing home, let us review your case for free.