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©2012 Naomi Campbell- Cornwall Hydration Project
Cornwall Hydration Project
Innovator and leadNaomi Campbell RGN
Supported by NHS Innovations South West and Peninsula Community Health CIC
focused on solving the long term problem of dehydration in elderly & vulnerable care
©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
All Parliamentary Hydration ForumHouse of Lords
Cornwall Hydration Project: National Profile 2010 -2012
Author Naomi Campbell 2011©2012 Naomi Campbell RGN Cornwall Hydration Project
2011 Naomi was
commissioned by the Nursing Times
©2012 Naomi Campbell- Cornwall Hydration Project
Dehydration in elderly care is avoidable...
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
How?
©2011 Naomi Campbell- Cornwall Hydration Project-VIP
Helping a frail elderly or vulnerable person to drink... Is NOT always a simple task... Above all it needs ‘time, kindness & patience’
Helping a patient to drink... Very little has changed over the past 50 years!
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’
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'
Universal agreement suggests a minimum of 1500mls per day is needed to prevent the
onset of dehydration
©2012 Naomi Campbell- Cornwall Hydration Project
A reminder... This study from 1984 highlights that
dehydration is a long term global problem in health care
2012 – dehydration remains a persistent problem
& is escalating along with the aging population
Despite many initiatives – why
does dehydration remain a problem?
HOW Can we support our
‘carers’ To
Solve this problemWHY
Is it still a Problem ?
How much longer must
elderly people suffer
©2012 Naomi Campbell- Cornwall Hydration Project
2005
Cornwall Hydration ProjectProvides a global ‘Birds Eye’ view
of the problem of dehydration...
The UKis not alone –
Dehydration of Vulnerable Infirm Patients
is an International problem
USA & Australia have led nursing research
But
More research is desperately needed..
Europe is working together through the
Cornwall Hydration Project - Naomi Campbell © 2012
©2012 Naomi Campbell- Cornwall Hydration Project
Ageing Population (millions)
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
2010
2025
2035
0.0 5.0 10.0 15.0 20.0 25.0
9.2
10.9
12.0
3.5
5.0
5.4
1.4
2.3
3.5
60-7475-8585+
Age Years
% UK population
©2012 Naomi Campbell- Cornwall Hydration Project
1000’smore will
require help to drink & eat
Cornwall Hydration Project - Naomi Campbell © 2012
•Tdddd
We know the risk factors
Dependent on Carers to safely hold a cup Reduced thirst response Reduced mobility
Dementia / Diuretics / Age / Disabilities COPD Swallowing problems
Drinks out of reach Too heavy to handleLoss of Dignity
↑ Demands on Carers “ the Nurses are so busy” ↑ Need for toilet ↑ Disturbance and pain
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'
Dehydration
why is it so complex?
No gold standard to measure or define dehydration
Normal Age related changes can mimic
dehydration symptoms
No absolute agreement on how much individuals should drink
Blood & urine tests can not reliably detect early
stages of dehydration
© 2012 Naomi Campbell 'Cornwall Hydration Innovation Project'
Universal agreement
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!
Simple well know symptoms provide a good indicator of hydration
e.g. Urine colour / dry mouth
Monitoring how much people are drinking is vital
©2012 Naomi Campbell- Cornwall Hydration Project
What is the actual cost of dehydration?
Nobody really knows as
dehydration is often not cited
as a primary cause
But we can safely say it is costing the NHS billions!
Helping a person to drink – saves lives and saves money
GP - Antibiotics
Increased nursing care
Pain & frequency
Anti-psychotic
medicationsHigh temp / m
alaise
Urine InfectionConfusion / d
elirium
Constipation LaxativesEnemas
Indignity
Loss appetite
Dizziness & FallsLoss of
confidence
Reduced mobility
PRESSURE
ULCERS
Injury
Loss appetite
Fractures Admission Surgery999 A&E Rehab Discharge
Length of stay& Costs
Acute Admission
Morbidity &Mortality
Risk Hospital AcquiredInfections
Early signs of dehydration
Acute Admission
Acute Admission
IV fluids Antibiotics
Medical expertise
Higherskill mix
Multiple medications
Loss of
independenceMalnutrition
© Cornwall Hydration Project – Naomi Campbell RGN 2012
©2012 Naomi Campbell- Cornwall Hydration Project
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