While many issues (immobility, medication) can play a role in care home residents developing constipation, poor hydration is the most common cause. If not properly treated, constipation can lead to fecal impaction, malnutrition and even death. Nursing homes have standing orders for treating most residents with constipation before it gets worse. Failure to hydrate residents or administer these orders is unacceptable.

Poor hydration, along with poor hygiene, can also lead to urinary tract infections (UTIs). If not properly addressed, such preventable infections can cause kidney damage, sepsis and death. Patients left lying in their own urine and feces are most in danger of these infections, but even patients with urinary catheters can be at risk if their tubing is soiled or staff fail to keep them hydrated or change collection bags.