“…This finding supports what has been documented in the literature concerning dehydration as an antecedent condition for acute confusion. The problem of under-hydration/dehydration in the long-term care setting, which by itself often leads to poor outcomes such as increased hospitalizations (Chappell & Murrell, 1994;Himmelstein, Jones, & Woolhandler, 1983;Palevsky, Bhagrath, & Greenberg, 1996), is well-documented in the literature (Armstrong-Esther, C., Browne, Armstrong-Esther, D., & Sander, 1996; Chidester & , 1997;Colling, Owen, & McCreedy, 1994). Further, several authors propose that dehydration can be prevented easily by vigilant nursing personnel (Hoffman, 1991;Kositizke, 1990) through the use of a structured hydration management guideline ).…”