Older adults can be particularly vulnerable to dehydration and achieving adequate hydration can be a challenge. The following information aims to summarise best practice in maintaining good hydration in your residents.

Signs that your residents haven't had enough to drink include:

  • Thirst
  • Headache
  • Dry mouth/lips
  • Tiredness
  • Feeling dizzy or lightheaded
  • Very small amounts of dark coloured, concentrated urine
  • Dry inflexible skin
  • Confusion

Good hydration in older adults may help prevent or treat:

  • Poor oral health
  • Constipation
  • Pressure ulcers
  • Low blood pressure which can increase falls risk
  • Urinary tract infections
  • Cognitive impairment
  • Increased risk of drug interaction and side effects.

How much should my residents drink?

Fluid requirements are very individual and are impacted by a variety of factors including body size, health and environment. In most adults about, 1.5 - 2 litres per day is a good target. That equals 6-8 drinks (based on a 250ml cup) of fluid per day, plus fluid from food.

This can be very challenging for some residents so aim for optimal hydration - achieving the best oral fluid intake possible under the present circumstances.

All fluid counts (except alcohol), including water, tea, coffee, milk, fruit juice and squash.

Many of your residents only drink when you offer them a drink so it's really important to:

  • Offer drinks more frequently
  • Offer different drinks (especially ones that the resident likes - do you know what their favourite drink is? Is it documented in their care plan?)
  • Offer food that has a high fluid content

High Fluid Foods

  • Soup
  • Jelly and milk puddings
  • Fruits with a high-water content such as watermelon and pineapple
  • Ice lollies
  • Sauces and gravies.

Good Hydration Practice

Identify residents who need assistance, ensure this is communicated to all staff and documented in care plans.

Use appropriate aids to help promote independence with drinking.

Make sure you know if your resident has swallowing difficulties and if they require thickener in their drinks, ensure this is communicated to all staff and documented in care plans.

Reassure residents that drinking more may not mean more visits to the toilet and that when they need to go assistance will be available if required.

If a resident has been identified as needing a record of their fluid intake, write down accurately the drinks that your residents have, and write down when you offer someone a drink, so you can demonstrate the care you are giving.

Consider the temperature and appearance of the drinks you are offering.

Make drinking enjoyable - why not include afternoon tea as part of your daily routine?

Increase the opportunity to drink, for example increasing the number of drinks rounds or offer more fluid with medications - every sip counts!

Remember, it is often more effective to offer a drink rather than ask if the individual would like one.

Tying together with 'MUST'

Some residents may be at risk of dehydration and malnutrition. For these residents, encourage 'nourishing fluids' to try and help increase fluid and calorie intake. Examples of these include*:

  • A glass of fortified whole milk
  • Hot chocolate or Horlicks made with fortified milk
  • Homemade milkshakes and fruit smoothies
  • Milky coffee made with fortified milk.

*Please refer to the 'Nutritional Care: Food First advice to promote weight gain' diet sheet for further details and recipe ideas. This can be found here: https://www.firstcommunityhealthcare.co.uk/support-to-gain-weight  

Note - Residents do not require a prescribed fluid intake unless this is identified and defined by a Dietitian or GP as part of their ongoing medical care. Residents who are receiving food and fluid requirements via a tube should have their requirements reviewed and revised by a Dietitian.

For further information please contact the First Community Dietitians: Telephone: 01373 777701 or email: firstdietitians@nhs.net  

Information taken from The Hydrate Toolkit: https://healthinnovationwessex.org.uk/news/1655/good-hydration-for-older-people-toolkit-now-available

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us, please contact:

First Community (Head Office)

Call: 01737 775450 Email:    fchc.enquiries@nhs.net    Text: 07814 639034

Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.

For office use only: Version 4  HPD_TS039 Publication date: May 2026