The I-Hydrate Project - about us

Improving hydration in older people in care homes to reduce morbidity and prevent hospital admissions.

Why is hydration important?

Keeping well hydrated is important for our physical and mental well-being. It's even more important as we age because a decline in the thirst reflex means older people tend to drink less and other changes such as loss of muscle tissue and kidney function affect the ability of the body to retain water. Older people with poor mobility may find it difficult to drink and may also restrict how much they drink because they are worried about getting to the toilet. Preventing older people from becoming dehydrated is important because it causes many adverse effects such as urinary tract infection, falls, delirium, and constipation and increases the risk of hospital admission.

A photo of a selection of different drinks in a row on a bedside table

Under-hydration has been recognised as a particular problem for people who are dependent on care staff to support their hydration.  The I-Hydrate research project was undertaken in two West London care homes and aimed to understand how care is delivered to support the hydration of residents and what simple measures could be introduced to optimise the fluid intake of care home residents and improve the quality and safety of care.

About the I-Hydrate project

This project aimed to understand and improve hydration care for elderly people living in residential care and was undertaken in two care homes in west London.  We started out by finding out how much fluid residents consumed, the way hydration was organised, delivered, and monitored, and worked with residents to test their fluid and drinking vessel preferences.

Lady in a hospital bed or care home, drinking a hot drink.

We found that most residents drank less than 1500ml a day, considerably less than the recommended intake of at least 2000ml for women and 2500ml for men.  Insufficient opportunities for residents to be offered or assisted to drink during the day was a key factor in the poor fluid intakes. Other factors such as a limited choice of drinks and cups that were difficult to hold made drinking more difficult for residents.

A nurse caring for a patient in a care home - they are both smiling and enjoying a moment.

We created a local project team in each home which included the unit manager, nurses, healthcare assistants, residents, and relatives. Using improvement science methods, we worked with the care home staff to design and test several simple strategies to make it easier for staff to support the hydration of their residents, to offer residents more choice of drinks and better cups to drink from. We were able to demonstrate that these changes increased the amount of fluid that residents drank and were associated with a reduction in the use of laxatives.

A care assistant showing a patient a selection of hot drinks on a menu.

We have used the findings from this study to create a set of practical resources for care homes, including an information pack and training videos, which can be downloaded for free from our website in the section below.

The I-Hydrate Resources

These resources will give you some ideas to help you support your residents with their hydration needs. They show that by making just a few small changes to the way in which hydration is provided can make all the difference to the amount of fluids residents consume.

"Hydration in care homes. A practical resource pack to support the hydration of care home residents", with a hot drink illustration next to the text.

The I-Hydrate Resource Pack

This describes the simple interventions that we used to improve fluid intake of residents and contains some basic training material for staff. 

For an accessible version of this file, please contact jennie.wilson@uwl.ac.uk.

You can download copies of the tools that are described in the resource pack and which we used to improve fluid intake of the residents. These include information posters, audit forms, a drinks menu, and improvement planning tools.

Training videos

Training videos

These short training videos were filmed in one of the care homes. They illustrate different aspects of supporting hydration care and demonstrate some of the key strategies we used to improve residents fluid intake.

Video 1: Introduction to hydration 
Video 2: Offering choice to residents 
Video 3: Protected drinks time
Video 4: Swallowing difficulties (Dysphagia) 
Video 5: how to position a resident and help them to drink

I-Hydrate infographic

A selection of hot and cold drinks on a table, including tea, fruit juice and squash.

I-Hydrate infographic

We've put together an at-a-glance guide to helping older people stay hydrated, whether you're looking after a relative at home, popping in on a friend, or caring for someone in a care home or hospital.

A lady holding a cup of tea and saucer.
Dehydration matters

Staying hydrated is essential for good health. Dehydration can cause: 

  • urinary tract infections (UTI) 
  • constipation
  • falls
  • hospital admissions.
Remove barriers to drinking
  • Make a choice of drinks easily available and in reach
  • Use cups that an older person can hold easily
  • Avoid heavy mugs or cups with small handles 
  • Encourage those who worry about incontinence to keep drinking.
An elderly man drinking orange juice from a glass in bed.
Identify signs of dehydration
  • Dry mouth or tongue
  • Headaches
  • Confusion
  • Drowsiness
  • Unsteadiness
Not just water
  • Getting enough fluid is what matters most
  • Water, squash, fizzy drinks, juice, tea, and coffee all count
  • Even fluid-rich foods like soup, jelly, ice cream, and yoghurt are important sources of fluid
Keep the drinks coming
  • Make sure older people have plenty of chances to drink
  • 1.5 litres is the minimum amount of fluid that adults need every day - this is equivalent to at least 8 large cups or mugs.

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