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The Hydration Gap: A Critical Issue in Nursing Homes
July 29, 2024
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Nursing homes face a significant hydration problem. Between 50% and 90% of nursing home patients are at risk for dehydration. This issue arises because many elderly individuals cannot achieve adequate hydration by drinking water alone, leading to comorbidities and an increased risk of early death.

The hydration gap often affects patients with weight loss, malnutrition risks, wounds, and infections. It is crucial to understand that water intake is not the same as hydration. While water intake involves getting water into the body, hydration means getting water into the cells. Proper hydration requires electrolytes, including essential vitamins and minerals, which many patients cannot obtain through diet and water alone. These patients frequently need acute care, sometimes resulting in hospital stays. Patients admitted to hospitals from nursing homes are ten times more likely to be dehydrated than those coming from their own homes. Even a 5% reduction in water intake can initiate the dehydration cascade.

The dehydration cascade involves an intracellular fluid shift, where the body moves water from vital organs into the bloodstream to balance extracellular fluid levels. This fluid shift impacts the brain, leading to worsened mood, heightened fatigue, and reduced cognitive ability. Consequently, severely dehydrated patients often withdraw and participate less in personal care. This results in poorer outcomes and an increased need for reactive interventions. Dehydration might seem like a simple problem, but it is challenging to solve. Approximately 51% of nursing home residents can be considered dehydrated, with 89% potentially severely dehydrated based on plasma osmolality.

The effects of dehydration in nursing homes are severe. Dehydration increases the risks of falls, prolongs surgical recovery, and contributes to longer hospital stays and higher mortality rates. Dehydration often starts with lab values, not prevention. Medications such as anti-diabetics, anti-convulsants, and anti-depressants exacerbate dehydration by depleting fluids. While lab values can confirm dehydration, they cannot prevent it. Certain blood conditions, such as elevated hemoglobin, low potassium, and elevated sodium, worsen dehydration's effects.

Many patients are unaware they are dehydrated due to cognitive decline, inability to communicate needs, and the natural decline in thirst signals with age. Additionally, aging reduces the kidneys' ability to concentrate urine, necessitating larger water intake for effective hydration. Even with adequate water intake, imbalanced electrolytes and micronutrients can prevent effective hydration.

Dript IV Therapy offers a science-backed solution developed by veteran clinicians to close the hydration gap. Their micronutrient supplementation provides essential nutrients to improve hydration and therapeutic outcomes. Delivered intravenously, these treatments rebalance intracellular fluid, reset the baseline for sustained oral hydration, and reduce health risks while improving cognitive function. These clinically proven infusions support comprehensive care plans and focus on nutrition rather than medication. 

Addressing the hydration gap requires a comprehensive approach. By implementing innovative treatments like those offered by Dript IV Therapy, nursing homes can improve patient outcomes and quality of life, ensuring residents stay healthy and hydrated.

Nursing Homes Have a Dehydration Problem. Here’s How to Fix It.

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Leveraging Legal Strategy and Case Law

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Applying Statutes and Regulations

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Anticipating Defense Tactics

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  • Extreme Weather Resilience: Metal roofs are inherently tough. They can withstand winds up to 140 mph, are highly resistant to cracking and corrosion, and do not suffer damage from hail impact as easily as brittle shingles. They are also non-porous, meaning they completely resist mold, mildew, and rot, which are common issues with organic materials.

2. Superior Energy Efficiency

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  • Reflectivity and Coatings: Most metal roofs today feature specialized reflective pigments and cool-roof coatings. These treatments reflect a significant portion of solar radiant heat away from the house.

  • Reduced Heat Transfer: By rejecting heat rather than absorbing it, a metal roof keeps the attic and the rest of the home cooler, reducing air conditioning costs by up to 25% during hot summer months. This inherent efficiency can even qualify homeowners for energy tax credits or rebates.

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In areas prone to wildfires or even in standard neighborhoods, a metal roof offers a vital layer of protection.

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  • Lightweight Advantage: Because metal is significantly lighter than tile or even asphalt, it puts less structural stress on the building's frame. In many cases, a new metal roof can be installed directly over an existing asphalt shingle roof, eliminating the costly and labor-intensive need for a full tear-off and disposal.

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1. Hardscaping

The biggest advantage of winter is visibility. Without the bushes and perennials covering everything, you can finally see the true topography of your yard. You can see exactly where the water runs off during a winter rain, where the erosion is happening, and where the privacy gaps are.

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This is why winter is the ideal time to install wire-and-stone features. Because they don't rely on mortar or cement, they are impervious to the freeze-thaw cycle that cracks traditional masonry. You can spend a cool Saturday filling baskets with rock to create a new retaining wall, a bench, or a garden border. By getting this heavy, structural work done now, you avoid compacting your soil in the spring when the ground is soft and wet. You also ensure that your garden beds are defined and ready for soil the moment the ground thaws.

2. Dormant Pruning

Many homeowners are terrified of pruning. They are afraid of cutting the wrong branch or hurting the tree. Winter actually makes this job much safer for the plant.

When a deciduous tree or shrub is dormant, it is essentially under anesthesia. The sap has descended to the roots, meaning the tree won't bleed or get stressed from the cut. Furthermore, without the leaves, you can actually see the architecture of the tree.

Look for the "Three D's": dead, damaged, and diseased wood. You can remove these safely at any time. Then, look for crossing branches that are rubbing against each other. Removing these now prevents open wounds in the bark that attract pests in the summer. Just be careful not to prune spring-flowering shrubs (like lilacs or forsythia), or you’ll cut off this year’s blooms. For oaks and elms, winter is the only safe time to prune to avoid transmitting wilt diseases.

3. Live Staking Propagation

This is a fun, zero-cost project that feels like magic. If you have dogwoods, willows, or elderberries, you can essentially clone them over the winter.

This technique is called live staking.

  • The Method: While the plant is dormant (late winter is best), cut off a straight branch about the thickness of a pencil.

  • The Action: Cut the bottom at an angle and the top flat (so you know which end is up). Then, simply shove the stick directly into the ground where you want a new shrub.

  • The Result: Because the energy is stored in the wood, the stick will focus entirely on root production as the ground warms up. By spring, that dead-looking stick will leaf out and become a new plant. It’s a fantastic way to create a privacy hedge or stabilize a creek bank for free.

4. Sheet Mulching

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  • The Method: Lay down thick cardboard over the grass where you want your new bed. Wet it down.

  • The Layers: Pile on your organic matter. Dead leaves, straw, vegetable scraps, and compost.

  • The Wait: Let it sit all winter under the snow and rain.

By spring, the grass underneath will be dead (and composted), the cardboard will have broken down, and you will have rich, dark, worm-filled soil ready for planting. You won't have to lift a shovel.

5. Tool Rehab and System Checks

Finally, take advantage of the downtime to care for your gear. We often put our tools away dirty in the fall.

  • Sharpening: A dull shovel or hoe makes gardening twice as hard. Use a mill file to put a sharp edge on your digging tools. Sharpen your pruners and loppers so they make clean cuts that heal quickly.

  • Oil: Wipe down wooden handles with boiled linseed oil to prevent cracking and splinters.

  • Irrigation Planning: You can’t turn the water on, but you can plan the layout. Walk your yard and flag where you need sprinkler heads or drip lines. If you map it out now, you can buy the parts during winter sales and be ready to install the moment the frost lifts.

Winter isn't a dead zone; it’s a prep zone. It’s the time to build the stage so that when spring arrives, the performance can begin immediately. By tackling the structure, the soil, and the tools now, you are setting yourself up for a season that is less about struggling with chores and more about enjoying the bloom.

 

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