Hydration Risk Assessment

Hydration risk assessment should be completed monthly and reviewed if there is a change in residents health and
wellbeing. The overall risk should be based on the highest category in which a risk factor is identified.

Name: Date completed:

Fluid restriction in place ☐ Yes / ☐ No

Weight:
Target fluid intake: ☐ Weight > 50kg: 1500–2000ml ☐ Or as per fluid restriction:
☐ Weight 40 – 50kg: 1200-1500ml
☐ Weight 35-40kg: 1000-1200ml
Independent or Risk factors for dehydration / Full support needed Complex needs
basic support carer support required for oral intake
needed
Dehydration Low Moderate High High with additional
Risk risk of fluid overload
Risk Factors: Please tick all that apply. Follow the risk category dictated by the highest scoring risk factor.
Assistance ☐ No assistance ☐ Difficulty handling ☐ Always needs a
for eating required. cups/cutlery, unable to pour carer to give full 1:1
and drinking their own drinks assistance to eat or
☐ Forgets to eat drink drink
☐ Dementia diagnosis
☐ Difficulty communicating
☐ Significant visual
impairment
☐ Requires significant
encouragement
Swallow ☐ No swallowing ☐ Requires thickened fluids ☐ High risk of choking
issues ☐ IDDSI levels 1 & 2 ☐ Requires thickened
fluid and support
☐ IDDSI levels 3 & 4
Clinical issues ☐ No significant ☐ Repeated UTI ☐ Diarrhoea or ☐ Fluid restriction
issues affecting ☐ Frequent falls vomiting e.g. renal dialysis
hydration ☐ Postural hypotension ☐ New confusion ☐ Enteral or
☐ Dizziness/light headedness ☐ New signs of parenteral feeding
☐ Taking water tablets dehydration ☐ High stoma /
☐ Open wounds ☐ Temperature > 38C ileostomy output
☐ High blood sugars ☐ Kidney impairment ☐ Recent
☐ Constipation ☐ Wounds with high chemotherapy
☐ Long term catheter drainage ☐ Excessive losses
☐ Urine colour score above 3

Monitoring Verbally check Complete hydration record in Complete hydration Recording of full fluid
with resident. residents where hydration record. balance of intake and
Observe general goal cannot be met with output
well-being simple interventions
Date: Risk status: Date: Risk status: Date: Risk status:

Page 1 of 1. Version 1 (March 2022) Review date: March 2025