Water for Wellbeing

Lovell House is a 40 bed low care aged care facility in the suburb of Caulfield, Melbourne. It is one of 12 Benetas facilities located in Victoria. Benetas Victoria has been providing not-for-profit aged care for over 60 years.

Benetas as an organisation has recently introduced what they refer to as focus months. This means that each facility will focus on a specific clinical indicator every month. The focus on the clinical indicator means that: staff members receive targeted training and education on the chosen focus topic; information is displayed in public areas; and, the topic will be raised at all meetings including, Occupational Health and Safety (OHS), resident/family and staff meetings.

The focus topic in February was "Falls", as dehydration and UTI's are often contributing factors to falls within the older population. One common element in the management of UTI's is fluid intake. With the release of the Water for Wellbeing Resource Kit for Residential Aged Care (Continence Foundation of Australia) Lovell House manager Rodney Xenitellis decided to implement this as a focus issue for his staff as a component of the falls prevention topic.

The first step was to launch the issue at a staff meeting. Staff welcomed the offer of further information on fluid intake as they are all aware that encouraging residents to consume adequate fluids can at times be a difficult task. The extra information and helpful tips were certainly welcomed. The topic was also raised at the OHS meeting and all members indicated their support for the topic being relevant to the falls prevention message.

Following this, all staff members were supplied a copy of the Water for Wellbeing Fact Sheet, they were encouraged to read it at their own leisure and discuss it amongst themselves. The fact sheet outlined the importance of fluid consumption in the older person. It also explained good and bad fluids and importantly some helpful tips on how to increase fluid intake in residents who were not meeting the recommended daily intake.

Once each staff member had received an opportunity to read and discuss the information they were given a questionnaire which focused on key points identified within the fact sheet. Staff completed the questionnaire independently and any incorrect answers were discussed with their team leader ensuring all staff completely understood the information presented.

Copies of the fact sheet were displayed throughout the facility in specifically targeted areas, including the main nursing office, the reception area, the tea room and the resident's notice board.

The resident and family newsletter produced by the staff at Lovell House also included an article addressing this issue. Family members were encouraged to join their loved ones in having a drink during their visit and to promote fluid intake when they took their family member on outings.

As a result of the increased focus on fluid intake, and the information provided in the fact sheet, staff members reported that they are able to increase the fluid intake of most residents in simple ways that do not usually result in refusal. They are now providing full glasses of water when administering medications instead of just a mouthful and the residents are encouraged to drink the full glass to remove the taste of the tablets. Staff are now delighted to report that in general residents are agreeing to these strategies.

Staff members are also providing a fluid round at least twice a day - once in the morning and once in the afternoon. Whilst initially not many of the residents were particularly receptive to this offer of an extra drink, the numbers involved are steadily increasing. Seeing other residents participate appears to have been enough encouragement to get the more reluctant residents involved.

Kitchen staff members have also become actively involved in the process at morning and afternoon tea and at supper time. They now pay particular attention to `at risk' residents and if the resident is not where they are expected to be at morning and afternoon tea times the staff member will locate the resident and take the fluids to wherever they may be.

UTI rates are now at minimal levels and there are signs that the falls rate has also been positively impacted by this strategy.

Infection Rate Graph reflecting the recent reduction in UTI's

The Water for Wellbeing Resource Kit is free and available to download from the website www.continencevictoria.org.au