Article Updated:  April 27, 2022

 Dehydration in Nursing Homes Legal Help

Dehydration in Nursing Homes is Neglect

It’s sad to say, but I have investigated nursing home injury claims where the resident basically died of dehydration.  When I see poor liquid intake, poor meal planning, and sudden onset or exacerbation of an acute kidney injury, I know dehydration likely played a role.

Having investigated and reviewed well over 500 nursing home injury claims, I know what to look for in the records to prove these claims, and which claims are viable for family members and injured residents to pursue.  If you or your loved one suffered a substantial injury due to dehydration in a nursing home, I invite you to email or call me for a free consultation.

Dehydration In Nursing Homes: A Common Problem

Dehydration in nursing home residents is a common problem and one that counts as a form of abuse and neglect.

The reason for this problem being common is that many causes of dehydration are found in high numbers in those who are in nursing homes.

This includes immobility, forgetting to drink liquids due to cognitive problems and the presence of illnesses like cancer which require medications that can cause dehydration.

As people age their bodies become less able to retain water and at the same time have a harder time detecting thirst.

Since these conditions happen at higher rates in nursing home residents, dehydration is a serious and common problem.

Nursing Home Neglect: Dehydration Happens Quickly

It does not take long for dehydration to set in and it also takes little time for dehydration to start causing serious medical conditions.

A 5%-8% loss of liquids in the body can lead to both dizziness and fatigue

Losing over 10% of body water can lead to severe thirst as well as mental deterioration and physical deterioration

◊ 15%-25% loss in body liquids can lead to shock followed by death

Dehydration in Nursing HomesThe quickness in which dehydration can occur, and the severity of the consequences means that it is seen as neglect in nursing homes.

It is particularly easy for nursing homes to prevent dehydration which is another reason that it is a form of abuse and neglect.

Dehydration affects blood pressure and organs like the liver, the brain and the kidneys as well.

Brain cells are in particular highly susceptible to harm in severe cases of dehydration.

Dehydration In Nursing Homes: Serious Physical Consequences

What are the consequences of dehydration and what is the prevalence of dehydration?

The presence of dehydration happens in high numbers in nursing homes and upwards of 30%-40% of nursing home residents at any point and time have some level of dehydration.

Some residents of nursing homes even have chronic dehydration with upwards of 17% of residents having multiple cases of dehydration over the course of a few months.

What causes dehydration to happen so frequently in nursing home residents?  Some frequent causes are:

Use of medications that cause higher thirst

Taking diuretics that cause increased urination

Increased sweating due to cancer medications

Illnesses that cause vomiting and diarrhea

Problems with swallowing that discourages drinking liquids

The consequences of these bouts of dehydration can range from benign health problems to very serious ones.

Common problems associated with dehydration in nursing homes are:

Kidney stones


Kidney failure

Blood clots


Swelling in the brain

Seizures caused by imbalanced electrolytes

Even seemingly benign consequences of dehydration can become life-threatening very quickly.  None of the potential consequences of dehydration should be taken lightly and the presence of even one means that the nursing home was neglectful in their duties.

Dementia And Dehydration In Nursing Homes

Another reason that nursing home neglect causes dehydration is the lack of proper attention given to those with cognitive problems.

Many who live in care homes are there as they need constant attention given to all of their needs.

This constant care is related to the presence of conditions like dementia and Alzheimer’s which makes remembering to drink enough liquids a problem in many residents of nursing homes.

Forgetting to drink water leads to dehydration over time.

If a resident becomes dehydrated this means that the nursing staff forgot to ensure hydration was being properly maintained.

Nursing home staff have an obligation and duty to make sure residents with cognitive problems are hydrated and they have many tools to help them make sure of this.

There are 49 potential risk factors for dehydration that nursing home staff can use to ensure residents are hydrated.

These risk factors also help to make sure dehydration is being identified early on and mitigated.

Any serious cases of dehydration mean a lack of care was put into the health of residents with cognitive concerns.

Can Dehydration In Nursing Homes Be Prevented?

Failing to provide residents with adequate hydration is a failure on the part of the nursing home staff.

When hydration is not confirmed and maintained it should be seen as a form of neglect.

The biggest reason that this is neglect is that the condition is so preventable.

The injuries and illnesses that are brought on by dehydration are also preventable and highlight how much influence nursing home staff have in stopping dehydration from becoming a problem.

Despite this potential influence to mitigate dehydration, the problem is chronic in large segments of nursing home populations.

Dehydration Risk Appraisal Checklist (DRAC)

Nursing homes have a large number of tools at their disposal to help reduce the chances for dehydration taking place in their residents.

DRAC Dehydration Checklist for Nursing HomesOne of these is the Dehydration Risk Appraisal Checklist (DRAC) that is used to measure dehydration risk in nursing home (NH) residents.

This checklist asks a number of questions of nursing home staff so that they can identify those who are higher risk,

Variables such as health conditions, medications, fluid intake behaviors, and laboratory abnormalities are all factors that can impact how susceptible a person is to dehydration.

The DRAC is not the only test available to assess dehydration risk and can be used in conjunction with other tools and measures to detect dehydration as soon as possible.

These additional tools also identify those who are higher risk for dehydration so that they can be monitored before dehydration even settles in.

Signs of Dehydration In Nursing

Another way that nursing homes can stop dehydration is to be aware of the signs of dehydration.

For nursing home staff there are a large number of signs that they can point out dehydration when it is starting to present itself.

Early signs of dehydration that nursing homes often overlook:


Muscle cramps


Dry mouth

Swollen feet


Loss of appetite

Low blood-pressure

Dark-colored urine

Increased heart rate

When nursing home dehydration symptoms are not caught early on it results in complications that can be considered nursing home neglect.

In addition to the early stages of dehydration, many additional late stage dehydration symptoms also exist:

High temperatures



Slurred speech



This is important because it shows that nursing home neglect is responsible for worsening dehydration.

With so many ways to catch dehydration early on, advanced cases mean that nurses and care staff have failed to identify and treat early cases of dehydration.

Treating Dehydration In Nursing Homes

Dehydration in nursing homes can be reversed in most early cases with the intake of fluids.

This does not work as easily with late stage cases of dehydration.

In severe cases there is the need for immediate medical care.

The need for serious intervention is even more likely when the individual is older, has an infection, are in end of life or have dementia.

In order for there to be effective dehydration treatment the nursing home needs have collaboration and communication with family members.

Dehydration has a much lower chance of being addressed when there are no clear roles and responsibilities for those who are caring for an older adult.

When clear roles are not established the risk of dehydration increases and treatment becomes less effective because the affected individual’s care becomes fractured.

The main reason for this is that multiple care professionals and informal caregivers rely on information from each other to address hydration which often leads to miscommunication.

Is Dehydration In Nursing Homes Neglect?

Dehydration in nursing homes is a form of neglect because it could be prevented with proper care and can lead to serious illness and death.

When symptoms are not caught in time and it leads to a person suffering, the dehydration can be seen as neglect in nursing homes.

Also, dehydration is not something that happens with one failed or negligent act of nursing.  It results from multiple acts of negligence.  Thus, dehydration is a sign of systemic disregard for a patient, and that is why it qualifies as a form of neglect.

Immobility and Dehydration In Nursing Homes

Many people suffer from dehydration in nursing homes because they are immobile and cannot get up to get water as frequently as another person.

Dehydration is seen as neglect in nursing homes because these immobile people are left to the mercy and care of nursing home staff.  If the staff do not do their jobs, then the individual who is immobile cannot take care of their basic needs themselves.

Neglect towards patients who cannot walk on their own and need someone to take care of them is therefore a basic function of what a nursing home needs to provide its residents.

Failing in this basic duty can only be described as neglect.

Dehydration Deaths In Nursing Homes

Dehydration coupled with lack of proper nutrition has led to hundreds of deaths every year in nursing homes.

Researchers have found dehydration deaths in nursing homes that are as high as 300-400 individuals a year.

The high presence of serious illnesses, strokes, immobility and cognitive decline all add to the high numbers of dehydration in nursing homes.

All of these are individuals who cannot speak up early on in their dehydration concerns.

If the nursing home staff are not diligent, this means that cases of dehydration will drag on for days or weeks before finally being caught when the staff are not paying attention.

When dehydration gets to the point of 15%-25% loss of bodily moisture the chances of death become exponentially higher.

Nursing Home Dehydration Lawsuit Q&A

Is dehydration nursing home neglect?

Yes, dehydration in nursing homes is a form of neglect because it is a preventable problem that nursing home staff need to be vigilant about addressing.

How frequent are dehydration deaths in nursing homes?

Dehydration in nursing homes is a frequent problem that commonly affects those who have mobility issues as well as cognitive function problems.  Rates of dehydration in nursing homes are sometimes as high as nearly 40% of the residents of the care home.

What level of dehydration causes death?

Dehydration at any level can cause serious health problems and complications from illnesses.  In order to get to the point of death, a person needs to achieve a 15%-25% loss of water from their body.

Do cognitive illnesses add to dehydration?

Cognitive illnesses do add to the prevalence of dehydration because they cause an individual to forget to drink water which leads to lack of proper hydration.

Which medications can cause increases in cases of dehydration?

Medications associated with cancer cause dehydration as do diuretics that can cause liquids to leave the body much faster than they can be replaced in the body.

Get Help With Your Nursing Home Dehydration Lawsuit

Nursing homes should offer safe environments where the health and well-being of a resident is secure.  When a nursing home fails in their duties it can lead to serious dehydration which can lead to health complications as well as death.

If you have been affected by the failings of a care home, then you will need a nursing home dehydration lawsuit to help you receive fair compensation for the pain and suffering caused by the incompetence of the nursing home.

I am here to offer you experience in cases just like this and am available at any time.

You can fill out the contact form below or email me for a free consultation.


Reza Davani, Esq.
State Bar No.:     #1212110211
Federal Bar No.: #30168

Cellphone: (301) 922-4598

Elder Abuse Lawyer

Paulis, S. J., Everink, I. H., Halfens, R. J., Lohrmann, C., & Schols, J. M. (2018). Prevalence and risk factors of dehydration among nursing home residents: a systematic reviewJournal of the American Medical Directors Association19(8), 646-657.

Mentes, Janet C., and Jeng Wang. “Measuring risk for dehydration in nursing home residents: evaluation of the dehydration risk appraisal checklist.” Research in gerontological nursing 4.2 (2011): 148-156.

Nagae, M., Umegaki, H., Onishi, J., Huang, C. H., Yamada, Y., Watanabe, K., … & Kuzuya, M. (2020). Chronic dehydration in nursing home residents. Nutrients12(11), 3562.

Paulis, S. J., Everink, I. H., Halfens, R. J., Lohrmann, C., & Schols, J. M. (2021). Dehydration in the nursing home: Recognition and interventions taken by Dutch nursing staff. Journal of Advanced Nursing.

Masot, O., Lavedán, A., Nuin, C., Escobar-Bravo, M. A., Miranda, J., & Botigué, T. (2018). Risk factors associated with dehydration in older people living in nursing homes: Scoping reviewInternational Journal of Nursing Studies82, 90-98.

About the Author

This nursing home and medical malpractice article was written by Baltimore, Maryland nursing home attorney Reza Davani, Esquire.  Mr. Davani received his Juris Doctor degree from a Tier 1 law school, the University of Maryland Francs King Carey School of Law.  He received his first license to practice law from the State of Maryland’s Court of Appeals (MD State License No. 1212110211), and just four months later received a federal law license from the United States District Court for the District of Maryland (Federal License No. 30168).

Mr. Davani has been practicing law for over 10 years.  He began practicing law by helping clients as a sanctioned student lawyer before receiving his law license, and second chaired his first jury trial in federal court before even graduating law school.  He is a registered member of the Maryland Association for Justice (MAJ), the American Bar Association (ABA), the American Association for Justice (AAJ), and was formerly on the MAJ’s Legislative Leader’s Circle.

Mr. Davani has taken over 20 cases to trial in state and federal court, and favorably settled well over 100 cases for injured victims.  He has personally helped his clients recover over $15,000,000 in personal injury, medical malpractice, and nursing home abuse settlements and verdicts in Maryland and other states.  He is dedicated to fighting for justice, and welcomes the opportunity to help you.

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