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Care home patients found dehydrated

Elderly care home patients are at least five times more likely to be dehydrated when admitted to hospital than those living independently, putting them at greater risk of death, according to new research.

Doctors monitored the sodium levels in more than 21,000 patients over 65 admitted to leading London hospitals during a two-year period and compared those who had come from care homes with those who lived in their own home.

Their findings, published in the Journal of the Royal Society of Medicine, suggested 12% of nursing home residents presented with hypernatraemia - high sodium levels associated with a lack of fluids - against 1.3% of others.

This meant those from care homes were twice as likely to die in hospital, doctors said, raising concerns over the levels of care provided in some institutions.

Lead researcher Dr Anthony Wolff of the Royal Free London NHS Foundation Trust said: "Our study shows that too many patients admitted to hospital from a substantial number of care homes are dehydrated, leading to unnecessary loss of life. High sodium levels in care home residents should raise questions about adequate support for drinking."

Professor Martin McKee of the London School of Hygiene & Tropical Medicine and co-author of the research paper added: "This raises serious concerns about the quality of care provided in some care homes. When a care home has more than a few residents admitted to hospital with high sodium levels this may well be indicative of a systematic problem at the care home and the issue should be raised formally."

The Royal Free Hospital NHS Trust, along with researchers from the University of Oxford and the London School of Hygiene & Tropical Medicine retrospectively reviewed a total 21,610 patients admitted to Barnet and Chase Farm Hospitals for the first time between January 2011 and December 2013.

After adjusting the results for factors such as age, gender and dementia the risk of high sodium levels was still over five times higher for those admitted from care homes.

The report concluded: "Patients admitted to hospital from care homes are commonly dehydrated on admission and, as a result, appear to experience significantly greater risks of in-hospital mortality."

Co-author Professor David Stuckler from the University of Oxford said: "Clearly this level of dehydration is a problem. Further research is needed to understand why it is occurring. Are care home residents choosing to drink less than they should? Or, as has been speculated, are care home staff not offering enough water to reduce incontinence and the amount of assistance their residents require?"

Care minister Norman Lamb said: "Failings of care that lead to people being dehydrated are completely unacceptable and if it is being done deliberately then this is abhorrent.

"The law on this is very clear - care homes must make sure residents get enough to eat and drink and we are making it easier to prosecute homes that fail to do so."

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