Valentina Giannelli, Dietitian at White Oaks, the senior living division of Compass Group UK & Ireland. discusses why care homes need a year-round strategy for meeting hydration challenges.
Between June and August this year, we had five heatwaves in the UK – a record for this country, and a pattern that looks set to continue. For older people, a heatwave can bring serious health risks, posing significant challenges for care home teams as they work hard to keep residents cool, comfortable and hydrated.
As we age, the body becomes less efficient at regulating temperature and thirst naturally declines, making it more difficult for people to consume enough fluids to meet their nutritional needs. Plus, many residents are living with heart, lung or other health conditions, and some medications can affect fluid balance or the way the body responds to heat.
During these periods of persistent hot weather, we see many reminders of the dangers of dehydration, an important response when heatwaves bring acute risk. However, what we must bear in mind is that dehydration in older people is a threat whatever the weather.
Hydration remains one of the most significant nutritional challenges in later life. Dehydration can have serious consequences for older individuals, including increasing the risk of falls, and contributing to or causing confusion, dizziness, fatigue, constipation and kidney problems. It can also lead to urinary tract infections, which in older adults frequently present with sudden disorientation and unsteadiness. Residents can be admitted to hospital following a fall that was, at its root, caused by not drinking enough.
A worrying statistic from researchers at the University of East Anglia, found that ‘one in four older adults has low-intake dehydration[1]. Over 65, the target is to drink up to three to three-and-a-half pints (or six to eight cups) of fluids per day. But, if thirst has declined and drinks are repetitive or uninspiring, intake can easily and quickly drop well below what the body needs to function safely.
For catering and care teams, the first response to this must be proactive. Hydration needs to be built into the day, not left for residents to ask for a drink. Alongside jugs of water and flavoured water in dining areas, plenty of hot and cold drinks should be provided between meals; this can be anything from fruit juice at breakfast to a chocolate milkshake with afternoon tea. Food services can also play a big role in hydration. Fruit, yoghurt, jelly, soup and ice cream all have a high liquid content and can make a useful contribution to overall fluid intake.
Core to the success of encouraging residents to keep hydrated is enjoyment. If food or drink is not appealing or enjoyed, it is not consumed, so this requires deliberate effort and creativity.
At White Oaks, we have just launched a new hydration range designed specifically by our culinary team to support the wellbeing of older adults. The Circadian Hydration Range is a collection of drinks designed around the natural rhythm of the day to help meet people’s hydration needs and is based on taste, aroma, colour, temperature and presentation. It features a fresh juice-based drink for the morning to gently stimulate the body and prepare for the day ahead; a smoothie-based ‘midday boost’ to provide nourishment and sustained energy; and a night-time warm milky drink to help relaxation and support better rest.
This initiative is about much more than fluids. It combines nutritional science with sensory engagement, creating an enjoyable experience that encourages people to drink regularly and supports their health and wellbeing. Our trials across several sites have been successful, so we’re working with our partners within assisted living and care homes to bring this to more residents across the UK and help overall wellbeing.
Our culinary team has also developed ‘Melting Moments’, a nutrient dense chocolate treat which can be enjoyed in solid or liquid form. They start as protein-fortified chocolate truffles and can double up as a rich hot chocolate when melted in warm milk.
Great food and drink are at the heart of great care. Drinks bring not just vital hydration and improved health but also pleasure and joy to residents every day. Who can deny the power of a comforting cup of tea or energy-boosting smoothie for changing our mood? The heatwave headlines look set to stay each summer, but hydration needs to be considered every week of the year.
[1] Parkinson E, Hooper L, Fynn J Low-intake dehydration prevalence in non-hospitalised older adults: Systematic review and meta-analysis Clinical Nutrition, 2023; 42, 1510-1520
