DRIE - Dehydration Recognition

in our Elders

DRIE - Dehydration Recognition In our Elders

    This website provides information about the DRIE Dehydration Recognition In our Elders study, what it is about, how it is set up and run and who to contact if you want to find out more.

Dehydration – what is the problem?

     Dehydration, when we don’t drink enough for our needs, is bad for all of us. In older people severe dehydration increases confusion and falls, and makes sudden hospital admission more likely. We don’t have a good method of recognising dehydration early, before it becomes severe. Being able to identify dehydration early would allow measures, such as extra encouragement with drinking, to prevent severe dehydration.

What will the research do?

     The research will identify an easy method that can signal when someone is in need of drinking more. We will do this by interviewing people living in care homes who are interested in this study.

    Care home staff will later receive training in how to recognise the early stages of dehydration.

     This research aims to improve health and wellbeing of older people in the community through:


1. Identifying a test or decision tree that can be used in residential care to identify early dehydration, so that prevention and treatment strategies can be rapidly mobilised.

     We will recruit 200 older people living in residential care (where dehydration is common). We will include those able to provide their own informed consent, and those for whom this is not possible. At baseline we will assess for water-loss dehydration (through serum osmolality) and measure promising markers of dehydration (such as dry mouth, tongue furrows, cognitive status, body temperature, dry under-arm, urine colour and specific gravity, feeling tired, headachy or thirsty, missing drinks, body temperature, cognition, pulse, orthostatic hypotension, fingernail capillary refill and foot vein filling) as well as collecting health and demographic information. We will use baseline data to assess diagnostic accuracy of each marker, then consider markers collectively to develop a decision tree to diagnose or rule out dehydration, while minimising testing.

This is part of the cohort study.

2. Making the test (decision tree) acceptable to older people and realistic for use in care homes, then checking the final test works well.

     This test will be refined through work with advisory groups of older people living in care homes, who will help us ensure that the final test is acceptable to older people, and a second group of care home staff who will make sure the test is fit and realistic for daily use in care homes. The final tool will be re-tested in a second population of older people.

More info on the advisory groups.

3. Clarifying associations between dehydration and health, functional status and quality of life in frail older adults.

     We will collect data on mortality, quality of life and functional status at 1 and 2 years from our 200 care home residents. This will allow us to clarify the predictive value of dehydration in longer term health in older people.

This is part of the cohort study.

4. Protecting against dehydration.

Systematic review of the existing research on effectiveness of external factors in reducing the risk of dehydration in older people living in residential care.

     As part of her PhD thesis Diane Bunn will investigate the current evidence for the effectiveness of interventions, or the impact of environmental conditions, on reducing the risk of, or reversing, impending water-loss dehydration for older people living in residential care.

Qualitative research to further our understanding of how best to support older people to drink plenty.

     Diane will be following up the systematic review with qualitative research to identify the best ways to support older people living in care homes in drinking plenty. More info on Diane's research.

Who is funding the research?

     The research will be funded by the National Institute for Health Research (NIHR). The funding is as part of a Career Development Fellowship to Lee Hooper, the researcher.

nihr

. : Contact us

If you have any questions or would like to participate please contact the lead researcher:

Dr. Lee Hooper,
Norwich Medical School, University of East Anglia,
Norwich NR4 7TJ, Norfolk, UK
Phone (mobile): 0781 391 7444
Email: l.hooper@uea.ac.uk

If anything goes wrong, or you have any worries or complaints about the conduct of the research please contact Lee or Sue Steel, the study sponsor, on 01603 591486 or email sue.steel@uea.ac.uk