Cornwall Hydration Project Innovator and lead Naomi Campbell RGN Supported by NHS Innovations South...

©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


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


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


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


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


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


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


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


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


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


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


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

Cornwall Hydration Project Innovator and lead Naomi Campbell RGN Supported by NHS Innovations South...

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