Malnutrition and Dehydration at Hospitals: Is It a Real Problem

How concerned should we be about dehydration and malnutrition in care facilities? We’ll explore this question in this article.

When we, or a loved one, is in a hospital or in a care facility, it’s reasonable to expect that, as well as receiving the best possible medical care, the patient’s comfort and ongoing recovery will be a top priority. Unfortunately, in recent years, medical negligence compensation claims in the UK have highlighted worrying levels of malnutrition and dehydration in patients and care home residents.

In this article, we’ll be exploring whether this is a real problem in UK hospitals. Take a look…

What is Dehydration?

Dehydration occurs when a person does not consume enough liquids. As well as leading to illness and even death as a standalone condition, it can very much lead to rapid deterioration of a patient’s health when suffering from other conditions.

What is Malnutrition?

Just as dehydration occurs through lack of liquids, malnutrition is the term used for a person not consuming enough food. Malnutrition can lead to the breakdown of bodily functions and organ failure and, ultimately, death.

Dehydration and Malnutrition in Care Facilities

Recent reports show that an incredible 45% of hospital patients will become dehydrated during their stay. Older people in particular can suffer severe health consequences due to dehydration which can lead to a number of dangers, including:

  • Constipation
  • Increased risk of falls and trips
  • Impaired cognitive function, including confusion
  • Orthostatic hypotension
  • Inability to produce saliva
  • Hypothermia

Additionally, patients with diabetes are at risk of poor hyperglycemic control when they become dehydrated.

Why do Hospital Patients and Care Home Residents Become Dehydrated?

There are a number of reasons for this, and these include:

  • Mobility: often, people in hospital and care homes have reduced mobility, which can mean that they are unable to reach water or soft drinks which are on their bedside tables or summon nursing staff for assistance. With increasingly overloaded care facilities, this can lead to patients being left for hours without water or other fluids.
  • Fear: older hospital patients will often be reluctant to drink sufficient fluids through fear that this will cause incontinence accidents and, subsequently, humiliation at needing their clothing and bedding changed.
  • Staff: most nurses and other medical employees are extraordinarily hard-working people, however, there are times, through either overwork or incompetence, that nursing staff will be waylaid. With this, they may fail to take into account patient preferences, fail to provide enough drinks, fail to properly document the patient’s fluid intake or, most seriously, fail to recognize the signs of dehydration.

Why do Hospital Patients Suffer from Malnutrition?

When we think about malnutrition, our thoughts tend to go to third-world countries, not hospitals in the western world. However, the fact is that, unbelievably, 29% of adults admitted to hospital suffer from malnutrition to a certain extent. Malnutrition can lead to a number of issues including:

  • Weakness and fatigue
  • Poor concentration and cognitive ability
  • Poor mobility
  • Slow healing of wounds
  • Exacerbation of illness
  • Decreased motor controls
  • Inability to stay warm

The reasons for hospital patients suffering from malnutrition may include:

  • Appetite: when in hospital suffering an illness or injury, many people simply do not have the appetite to eat an adequate amount, which can lead to malnutrition.
  • Quality: ever-decreasing budgets mean that food in hospitals is often unappealing and lacking in variety. As well as failing to appeal to patients, this can lead to a vicious circle. In many cases, hospital staff will monitor the patient’s food intake and, although family and friends may bring the patient food from outside, some patients will be reluctant to eat this, knowing that it will impact on the amount of hospital food that they consume which, when recorded, may impact on the length of their stay.
  • Health condition: in some, thankfully rare, cases, hospital or care home staff will fail to notice that a patient or resident is suffering from a condition or difficulty, for example, difficulty in swallowing, which may be preventing them from consuming enough food during their stay in hospital.

In some extreme cases, patients with a terminal illness may simply refuse to eat as they feel that fueling their body is simply prolonging what has been an existence with little quality of life. In some instances, this may mean that a patient is then fed intravenously, but this is a complex area that is handled on a case-by-case basis.

Are Dehydration and Malnutrition Real Problems in UK Care Facilities?

In recent times – particularly during and following the COVID-19 pandemic – the NHS and the UK care sector have faced a fair amount of criticism, much of which is undeserved. Ever diminishing budgets and staffing issues have meant that these sectors are under more pressure than ever before, with resources stretched impossibly tight.

Malnutrition and dehydration within the care and medical sectors is very much a form of medical negligence; one which is leading to increased claims for compensation, resulting in significant payouts. This, unfortunately, puts even more pressure on organizations like the NHS, whose budgets are already stretched to breaking point.

Between 2020 and 2021, the NHS paid out a total of £2.6 billion in compensation claims; £50.7 million of which was down to non-clinical negligence claims, including dehydration and malnutrition. It’s clear that urgent attention is needed when it comes to dehydration and malnutrition – conditions that simply should not be happening in UK hospitals and care homes.


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