Malnutrition and Dehydration in Nursing Homes

Malnutrition and dehydration are typical problems in many nursing homes and long-term care facilities. Malnourished and dehydrated residents are far more likely than those who receive proper nutrition and fluids to suffer from poor health. The failure of a nursing home to provide adequate fluids and food is a form of nursing home abuse.

Elderly woman in grief

Residents who are dehydrated and fail to get enough food are more prone to weakness, poor cognitive performance, and infections. They are also at higher risk of falling, developing bedsores, and having higher degrees of immobility. Further, dehydration and malnourishment weaken the immune system, making the residents more prone to pneumonia and other conditions common in long-term care facilities.

Many residents in nursing homes have serious health conditions requiring a clean environment. Failing to provide a sanitary space for seniors may lead to infections and the rapid spread of contagious diseases. Therefore, the right hygiene is essential. If your loved one is injured because a nursing home did not maintain a clean facility, then you may be able to pursue a claim for nursing home abuse or neglect.

We have put together this document to help you understand the importance of nursing home hygiene and when poor hygiene may result from nursing home neglect.

Is malnutrition common in care homes?

Dehydration and malnourishment are two of the most typical forms of nursing home neglect. In many cases, these two conditions are found together. If a resident in a nursing home setting is dehydrated, she is likely malnourished as well, and this should be reported and brought to the long term care facilities attention.

According to a 2020 meta-analysis in Nutrients, “The overall prevalence of malnutrition in the elderly ranges from 1% to 24.6%. In addition, 50% of the elderly in rehabilitation, 20% in residential care, and 40% in hospitals are malnourished. As a result of population aging, the malnutrition prevalence is increasing, which is expected to reach 29.1% by 2080.”

What are the signs of malnutrition in the elderly?

According to a narrative review in Maturitas: an international journal of midlife health and beyond, “There are several causes of malnutrition in the elderly that lead to depletion of muscle including starvation (protein-energy malnutrition), sarcopenia and cachexia. The prevalence of protein-energy malnutrition increases with age and the number of comorbidities.”

Dehydration and malnutrition in elderly residents of nursing homes can cause serious health complications, including:

  • Hypotension (low blood pressure)
  • Urinary tract infection
  • Electrolyte imbalance
  • Renal (kidney) failure
  • Abnormal skin tone
  • Muscular atrophy
  • Muscle weakness
  • Weight loss
  • Confusion
  • Bedsores

Other possible side effects of dehydration and malnutrition include dry mouth, dry skin, vomiting, diarrhea, mouth sores, tremors, difficulty eating, poor digestion, and adverse interactions with medications.

According to 2018 research, “Undernutrition is defined as an imbalance between the body’s energy intake and requirements. It is present in 30% to 70% of hospitalized elderly people, and its consequences are severe. Systematic screening and early treatment are an integral part of global geriatric care.”

Unfortunately, chronic depression, Alzheimer’s, coma, and death are other possible risks associated with long-term dehydration and malnutrition. Water and nutrients are crucial to our bodies. Without adequate amounts of both, we develop risk factors to suffer from a variety of possible adverse effects.

What are the causes and risks of dehydration in elderly people?

There are various possible causes of dehydration in elderly nursing home residents and some can also be signs of potential nursing home abuse. Some of the most common include untrained or unavailable nursing home staff to assist residents who need help with drinking and residents who are dependent on liquid supplements.

According to 2018 research in Clinical Nutrition, “A range of effective interventions is available to support adequate nutrition and hydration in older persons to maintain or improve nutritional status and improve clinical course and quality of life. These interventions should be implemented in clinical practice and routinely used.”

The human body is composed of more than three trillion eukaryotic cells. Each of those cells requires constant hydration to perform optimally. If someone is chronically and systemically dehydrated, their cells suffer in all areas of the body. Inadequate fluid intake and unmet nutritional needs can cause an increased risk of complications anywhere in the organism, from the toenail to the knee ligament, the hip joint, the heart, the ear, to the brain.


Why does dehydration occur in nursing homes?

If a senior is being properly looked after and cared for in a nursing facility, there’s no reason that dehydration or nutrition should occur.

The entire purpose of nursing facilities is to provide the necessary care for an individual to live their best life, even in the face of debilitating medical conditions. Plenty of fresh water and nutritional food should be available to every resident every day.

Even a 10% decrease in hydration can cause serious health problems. And a 20% decrease in hydration can cause death. That’s why it’s so important for nursing home staff members to be attentive to the residents that they serve. Elderly people in nursing homes may well suffer from cognitive insufficiencies that disallow them from knowing when they should eat or drink.

According to research in the Journal of Gerontological Nursing, “Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause.”

Dehydration may also result from prescription medications, having a fever, vomiting, depression, and general malaise. It’s the responsibility of the nursing home staff to monitor the resident’s hydration and nutrition levels, a failure to do this would be abuse due to neglect or malfeasance in the nursing home. Understaffing issues must be amended. Inadequate staffing at mealtimes is problematic.

Proper water intake is a vital component in maintaining human health for all people, young or old.

Holding Nursing Home Care Providers Accountable

According to research from the Journal of Nutrition for the Elderly, “Nutrition is a major problem in nursing homes, as evidenced by up to 85% of elderly people suffering from malnutrition. Nutritional deficiencies are frequently not recognized, are often the common underlying cause of adverse clinical outcomes, and are often not treated even though opportunities for preventing or correcting undernutrition are available.”

If you suspect that your loved one in a nursing home is suffering from dehydration, malnutrition, bedsores, adverse drug interactions, cognitive impairment, emotional indifference or any other sign of nursing home abuse, you should act immediately. Time is of the essence. Once started, the adverse effects of malnourishment and dehydration on health care can intensify quickly.

Medically Reviewed by:

Dr. Patricia Shelton, MD

Picture of a woman smiling


  • University of Washington, Doctor of Medicine – MD. June 2008
  • University of Washington, Bachelor of Science – BS, Jun 2003


Neuroscience and Medicine


  • Dr. Shelton primarily writes content for health-related websites, but has also written test prep materials, white papers, published research articles, court documents, and more.
  • Dr. Shelton teaches anatomy and physiology at the college level for the National Institutes of Health.

Do You Need Help?

Legal Help

Icon of love

Nursing Home Abuse Should Have Consequences.

Fact Checked

Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.