Expert Voice: Nutrition and Hydration Week

By Damian Lacey, Advanced Practitioner

Nutrition and hydration are essential components of palliative and end-of-life care, supporting both physical comfort and overall well-being. A person-centred approach is crucial to addressing individual needs, considering the complex interplay of physical, emotional, social, and spiritual factors that affect dietary intake and fluid levels. (Quinn (2022); Wells & Pearce (2025)).   

We are planning a week of activities at Moya Cole to highlight the importance of nutrition and hydration for our patient group. This initiative aligns with a national campaign that emphasises the role of food and drink in health and social care settings, promoting activities, awareness, and improvements in nutritional support for everyone, from patients to the public.  

Why staying hydrated and eating well is good for you 

Maintaining proper hydration and eating a balanced diet are essential for overall health, affecting physical performance, mental function, and the prevention and management of various health issues. These lifestyle choices play a key role in a person’s ability to handle daily challenges and maintain a balance between themselves and their surroundings. (Blake H (2024); Reis da Silva TH (2024)) 

• Fluid Balance and Health: Water is essential for maintaining blood volume, cellular stability, and transporting gases, nutrients, and waste products throughout the body. Sufficient fluid intake prevents dehydration, which can impair cognitive function and physical performance, especially in vulnerable groups like young children and older adults. (Reis da Silva TH (2024)) 
• Dietary Fibre Benefits: Consuming enough dietary fibre helps prevent and manage chronic conditions such as type 2 diabetes, neurodegenerative diseases, cardiovascular disease, and cancer. It also helps retain water in the large intestine and increases faecal bulk, making going to the toilet easier and reducing the risk of constipation. (Wells L, Pearce R (2025); Douglass E, Wilson P (2025))
• Nutrient Intake: A balanced diet guarantees sufficient intake of micronutrients (vitamins and minerals) vital for maintaining health, energy, mental clarity, and overall performance. Deficiencies may cause serious health problems.  (Wells L, Pearce R (2025)) 
• Weight Management: Eating a balanced diet lowers the risk of obesity, which is linked to cardiovascular disease and stroke. Healthy eating, combined with physical activity, aids weight control and helps regulate blood glucose levels. (Rees H (2025); Butler S (2025)) 
• Blood Glucose Regulation: Increasing dietary fibre intake and cutting down on sugary foods and drinks are essential for preventing blood glucose spikes and maintaining stable glycaemic levels, especially in managing type 2 diabetes. (Butler S (2025))
• Overall Diet Quality: Focusing on overall diet quality, including consuming more vegetables, fruits, pulses, and cereals, is more important than merely avoiding “ultra-processed” foods, as processed versions of these healthy foods can be convenient and affordable. (O’Hara B, Beaumont J (2025)). 
• Health Promotion: Health promotion, which includes educating individuals about healthy eating and hydration, aims to enable people to gain control over and enhance their health by fostering supportive environments and strengthening social networks (Blake H (2024)) 

Staying hydrated and eating well are essential parts of a healthy lifestyle, helping to prevent disease, enhance physical and mental performance, and promote overall well-being. These practices are key to health promotion efforts at individual, organisational, and national levels. 

Why staying hydrated and eating well is good for your joints and muscles 

Most signs of dehydration, such as thirst, muscle cramps, and light-headedness, appear only when dehydration is severe. Milder dehydration can cause symptoms such as joint pain and muscle stiffness, which can affect daily life. 

Staying hydrated and eating a nutritious diet with fruits, vegetables, lean proteins, whole grains, and healthy fats supports joint and muscle health, improving mobility and flexibility. Water lubricates joints; synovial fluid, which cushions joints, is mostly water. Proper hydration reduces friction, preventing pain and stiffness. ((MAC Clinical Research, 2025)  

A high-quality diet provides essential nutrients, including vitamins, minerals, and antioxidants, to support healthy joints. Calcium and vitamin D strengthen bones and cartilage, reducing musculoskeletal issues. Adequate protein supports muscle repair and growth, aiding activity and recovery.  (Webster et al., 2023) 

Maintaining a healthy weight is crucial; excess weight stresses joints and increases inflammatory mediators, raising pain and impeding recovery. Improving diet and increasing activity are key steps for better weight management. (Arthritis Foundation, 2023) 

15 tips to stay hydrated and eat well throughout the day, every day:  

1. Begin each day by drinking a tall glass of water when you wake up. 
2. Keep a water bottle at your desk to sip throughout the day.
3. Always drink a full glass of water before lunch and dinner.
4. If you need a reminder, set a timer on your phone to send a notification when it’s time to drink. 
5. Consider using a water-tracking app to measure how much water you are consuming each day.
6. Carry a reusable water bottle with you when leaving the house. 
7. Choose water over other beverages
8. If you don’t enjoy the taste of water, try adding a bit of flavour with a squeeze of lemon. Alternatively, you can purchase low-calorie water enhancers to mix into your drink.
9. If you prefer hot drinks to cold, try herbal teas, which are considerably less dehydrating than their caffeine-containing counterparts.
10. Start keeping a food diary to become aware of the food you are eating.
11. Before thinking about the amount of food you’re consuming, aim to improve the quality of your food by looking at resources such as the Eatwell Guide to see what good quality food sources look like.
12. Pick a sustainable food structure that works for you for 80% of the week and build your meals and snacks around this. Try to schedule in the other 20% to enjoy meals in or out with friends and family.
13. Set achievable goals in the short term (1-3 months), medium term (3-6months) and long term (6-12 months).
14. Be prepared and plan for the week to ensure you stay on track. This might be cooking in bulk or menu planning, which will ensure you have the right foods to hand and are less likely to snack on unhealthy options.
15. The more sustainable your plan is, the better the results. Think long-term, not short-term.  

What are the consequences of dehydration? 

Dehydration, when the body lacks sufficient fluids, can cause adverse physical and cognitive effects across all ages, especially in children and older adults. Proper hydration is vital for health, supporting bodily functions like maintaining vascular volume, cellular homeostasis, and nutrient transport. 

• Cognitive Impairment: Mild to moderate dehydration can significantly impair cognitive function, affecting concentration and mental clarity. This impact is particularly pronounced in older individuals and those with dementia. (Rees H (2025))
• Physical Performance: Dehydration negatively affects physical performance, especially in young children and older people.  (Swinnerton E, Price A (2023))
• Kidney Health: Frequent, even mild, dehydration can lead to kidney damage, increasing the risk of kidney stones and potentially chronic kidney disease. Severe dehydration has been linked to acute kidney injury and failure. (Price A, Cookson K (2021))
  Bladder Problems: Insufficient hydration can cause concentrated urine, leading to overactive bladder symptoms and increasing the risk of urinary tract infections (UTIs). (Reis da Silva TH (2024); Price N, Wood AF (2023))
  General Discomfort: Common physical symptoms of dehydration include headaches, tiredness, and constipation. (Rees H (2025))
  Delirium and Confusion: In older individuals, dehydration can result in delirium and confusion, which in turn can negatively impact nutritional intake. (Waight S, Board M (2024))
  Increased Mortality Risk: Dehydration exacerbates existing health concerns, particularly frailty in older people, and has an impact on mortality and hospital admissions. (ElSharkawy et al., 2017))
• Electrolyte Imbalances: Dehydration can lead to fluid and electrolyte imbalances, which are critical in emergency conditions like severe burns, sepsis, and major trauma, and can also occur with long-term conditions such as heart failure and diabetes mellitus. (Swinnerton E, Price A (2023))
  Vulnerability in Specific Populations: Older adults are at an increased risk of dehydration due to factors like suboptimal oral intake, chronic health conditions, and reduced gastrointestinal absorption. (Swinnerton E, Price A (2023)) 

Older adults are at an increased risk of dehydration due to factors like suboptimal oral intake, chronic health conditions, and reduced gastrointestinal absorption 

Importance of recognising swallowing difficulties in patients with life-limiting illness 

Recognising and managing dysphagia, or swallowing difficulties, is essential for patients with life-limiting illnesses as it profoundly affects their quality of life and can cause serious health complications. Healthcare professionals play a crucial role in detecting dysphagia through comprehensive assessments and implementing personalised interventions to reduce risks and enhance patient well-being. 

• Consequences of Unmanaged Dysphagia: Suboptimally managed dysphagia can lead to serious outcomes such as weight loss, dehydration, choking, malnutrition, pneumonia, and increased mortality rates. For individuals with dementia, dysphagia doubles the risk of death from aspiration pneumonia. (Murphy JL (2022))
• Identification and Assessment: Health Care staff are crucial in assessing nutritional status and identifying signs of dysphagia, which may include excessive saliva production, coughing or choking while eating, gurgling while talking, and feeling that food gets stuck. Oral health assessments are also vital, as impaired neuromuscular control and dysphagia can make it difficult to clear food debris. (Thayaparan T, Doshi M (2025)) 
• Management Strategies: Interventions include supporting patients into an upright position during meals to improve food intake and reduce aspiration risk. For those with learning disabilities, modifying food textures is necessary due to oral-motor difficulties. Occupational therapists can assist with adaptive utensils, and speech and language therapists address swallowing issues through exercises and activities, improving confidence and quality of life. (Swinnerton E, Price A (2023); Curran MC (2025)) 
• Impact on Quality of Life: Dysphagia not only has a detrimental effect on a person’s quality of life but can also indicate ongoing physical decline. Effective management can significantly improve patients’ ability to participate in daily activities and enhance their overall well-being.  (Morton-Nance S (2019)) 

The timely recognition and proactive management of dysphagia in patients with life-limiting illnesses are essential to prevent severe complications and enhance their quality of life. Healthcare professionals must employ thorough assessment techniques and multidisciplinary interventions to address this complex issue effectively.  (Swinnerton E, Price A (2023); Murphy JL (2022); Curran MC (2025)) 

Now why not try your hand at this fun Quiz to test your knowledge.   

References 

Arthritis Foundation. (2023). Weight loss benefits for arthritis. https://www.arthritis.org/health-wellness/healthy-living/nutrition/weight-loss/weight-loss-benefits-for-arthritis [arthritis.org] 

Blake,H.Applying health promotion knowledge to self-care: healthy eating and weight management for nurses. Nursing Standard, doi:10.7748/ns.2024.e12393 

Butler,S.Type 2 diabetes and the role of nurses in its management. Nursing Standard, doi:10.7748/ns.2025.e12429. 

Curran,M.C.Oral health and learning disabilities: the role of nurses in breaking the cycle of inequality.Learning Disability Practice, doi:10.7748/ldp.2025.e2284. 

El-Sharkawy, A. M., Virdee, A., Wahab, A., Humes, D. J., Sahota, O., Devonald, M. A. J., & Lobo, D. N. (2017). Dehydration and clinical outcome in hospitalised older adults: A cohort study. European Geriatric Medicine, 8(1), 22–29. https://doi.org/10.1016/j.eurger.2016.11.007 

El-Sharkawy AM, Bragg, D, Watson, P, Neal, K, Sahota, O, Maughan, RJ, Lobo, DN (2016) Hydration amongst nurses and doctors on-call (the HANDS on prospective cohort study). Clinical Nutrition; 35: 4, 935-942MAC Clinical Research. (2025, March 18). Nutrition & hydration for joint health: Supporting knee osteoarthritis. https://researchforyou.co.uk/mac-news/nutrition-hydration-for-joint-health-supporting-knee-osteoarthritis/ 

Morton-Nance,S.Drug-induced dysphagia and the high-risk effect on people with intellectual disabilities.Learning Disability Practice, doi:10.7748/ldp.2019.e1955. 

Murphy,J.L.Improving nutrition and hydration in older people with dementia in care homes.Nursing Older People, doi:10.7748/nop.2022.e1389. 

O’Hara,B., & Beaumont,J.Unpacking ‘ultra-processed’ foods: what nurses need to know.Nursing Standard, doi:10.7748/ns.2025.e12526. 

Quinn,B.G.Providing palliative and end of life care for people with advanced disease.Nursing Standard, doi:10.7748/ns.2022.e11780. 

Reis da Silva,T.H.Understanding body fluid balance, dehydration and intravenous fluid therapy.Emergency Nurse, doi:10.7748/en.2024.e2201. 

Swinnerton,E., & Price,A.Recognising, reducing and preventing deconditioning in hospitalised older people.Nursing Older People, doi:10.7748/nop.2023.e1396. 

Thayaparan,T., & Doshi,M.How to undertake an effective oral health assessment.Nursing Older People, doi:10.7748/nop.2025.e1501. 

Wells,L., & Pearce,R.Exploring the importance of diet in healthy ageing.Nursing Standard, doi:10.7748/ns.2025.e12480. 

Waight,S., & Board,M.How to undertake a holistic nutritional assessment with older people.Nursing Older People, doi:10.7748/nop.2024.e1481. 

Webster, J., Dalla Via, J., Langley, C., Smith, C., Sale, C., & Sim, M. (2023). Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein. Bone Reports, 19, 101684. https://doi.org/10.1016/j.bonr.2023.101684