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Dehydration in a deteriorating elderly patient (March 2014)

In a finding of 21 March 2014 the SA deputy State Coroner delivered findings into the death of a woman aged 73 at Wallaroo Hospital as a result of pneumonia and renal failure with hypothermia. The deputy Coroner made a number of recommendations in the finding including to the Minister, Aged and Community services and AMA. The recommendations are:

  1. That strategies be developed, reduced into writing and utilised in aged care facilities to ensure the recognition of the deteriorating resident by aged care facility staff that includes reference to the circumstances in which medical assistance should be sought in relation to the resident, to the circumstances in which transfer to a hospital should be considered, the need to ensure adequate hydration in the deteriorating resident and the need to ensure that proper records are made in respect of the hydration of the deteriorating resident;
  2. That strategies be developed, reduced into writing and utilised in aged care facilities to ensure that undue reliance is not placed on urinalysis in order to determine hydration status, and addressing the need for aged care facility staff to communicate by phone or word of mouth when urgent communication with a medical practitioner about a deteriorating resident is required;
  3. That the Australian Medical Association bring these findings to the attention of its members, and in particular to the attention of medical practitioners who practice in rural areas and in aged care facilities within those areas.  The Association should remind its members that they should carefully consider the question of dehydration in a deteriorating elderly patient, not to rely only on clinical impressions regarding the same and to have regard to the importance of blood testing in the identification of dehydration.

Members are encouraged to find out more from the full finding on the coroner's website here.