Elder Abuse: Dehydration and Malnutrition in Nursing Homes

Dehydration and malnutrition are among the most serious health risks affecting nursing home residents. Untreated, they can lead to life-threatening complications, including infections, organ failure, and even death. Residents who are physically frail, cognitively impaired, or unable to communicate their needs are particularly vulnerable.

Let’s look at what these conditions are, when they may constitute elder abuse and neglect, and what regulations California and federal policymakers have implemented to protect vulnerable nursing home residents from these serious, preventable afflictions.

Understanding Dehydration & Malnutrition

Dehydration occurs when the body loses more fluids than it takes in, disrupting essential bodily functions. Symptoms can range from mild—such as dry mouth and dizziness—to severe, including confusion, rapid heart rate, and organ failure. In long-term care settings, dehydration is often caused by inadequate monitoring of fluid intake, lack of assistance with drinking, or side effects from medications that increase fluid loss.

Malnutrition arises when the body does not receive enough essential nutrients to maintain health. This can be attributed to poor-quality meals, insufficient food intake, or medical conditions that interfere with digestion or absorption. Left untreated, malnutrition can lead to serious health issues including a weakened immune system, muscle wasting and pressure ulcers.

When Does It Become Elder Abuse or Neglect?

Dehydration and malnutrition are widely recognized as red flags for elder abuse and neglect —largely because they are so easy to prevent and treat. When nursing home staff fail to ensure residents receive proper nutrition and hydration, it may constitute neglect under California law. Specifically, the Elder Abuse and Dependent Adult Civil Protection Act defines neglect to include the “failure to prevent malnutrition or dehydration.”

Federal regulations are similarly clear that nursing homes and other long term care facilities have a duty to maintain residents’ nutrition and hydration. Facilities are obligated to ensure that each resident “maintains acceptable parameters of nutritional status, such as usual body weight or desirable weight range and electrolyte balance,” unless this is medically contraindicated or inconsistent with the resident’s own preferences.

If you suspect your loved one has suffered due to neglect, an experienced elder abuse attorney can help you determine whether the situation warrants legal action.

At-Risk Groups

Many nursing home residents rely entirely on staff to meet their nutritional and hydration needs. Certain groups face heightened risks and require increased attention. Risk factors for malnutrition and dehydration include:

• Dysphagia: Those with dysphagia or other swallowing difficulties may avoid eating or drinking to prevent choking or aspiration. Special diets—such as pureed foods or thickened liquids—can help, but may not fully resolve the issue.
• Old Age: Quite simply, aging naturally reduces the body’s hunger and thirst signals. When combined with chronic conditions, limited mobility, and side effects from medications, the aging process makes older adults particularly prone to dehydration and malnutrition.
• Certain Medications: Diuretics, laxatives, and some psychiatric drugs can increase fluid loss or suppress appetite. These residents must be closely monitored to avoid dangerous deficits.
• Cognitive Impairment: Individuals with Alzheimer’s or dementia may forget to eat or drink, struggle to express their needs, or resist assistance. They often fail to recognize hunger or thirst on their own.
• Physical Disability: Bedbound or immobile individuals often depend on staff for help with meals and fluids. Without prompt assistance, they are especially susceptible to dehydration and malnutrition.
• Chronic Illness: Conditions like diabetes, kidney disease, and gastrointestinal disorders often require specific dietary and hydration management. Inadequate care can result in serious complications, including blood sugar imbalances or electrolyte disturbances.

Seeking Legal Recourse through an Elder Abuse Attorney

While dehydration and malnutrition are serious risks in California nursing homes, both conditions are easily preventable if facilities address them proactively. Protecting our vulnerable senior citizens from unnecessary suffering is paramount. If your loved one has suffered from dehydration or malnutrition while in a nursing home, you may have legal options. A Los Angeles elder abuse attorney specializing in elder abuse and neglect in California nursing homes can assess the situation and help determine whether you have grounds for a lawsuit.