The PhD project encompassed three studies.

The first study was a systematic review which established the prevalence of low-intake dehydration (from not drinking sufficiently), amongst non-hospitalised older adults using only robust measures. The second study (D-DRINC Study A) was an ethnographic study which explored how older residents living with dementia, drank within in a single care home. D-DRINC study A looked at the care home as a complex system, in which residents, staff, visitors and health professionals all act and interact. The rich and nuanced data which were generated from the ethnographic observations and interviews with staff and residents has provided us with a more nuanced understanding of drinking, which will enable evidence-based drinking interventions to be developed in care homes in future. The third study (D-DRINC Study B) was a thematic discourse analysis of online posts from a public discussion forum, to explore how people living with dementia drink in long-term care settings. Findings between D-DRINC studies A and B were compared and contrasted.

Key Research Aim

This mixed-methods PhD project aimed to better understand the complex issue of low-intake dehydration amongst older adults, particularly those living with dementia in long term care settings, and to explore ways of promoting and improving drinking for these individuals.

Research Design and Outputs

This PhD project used mixed-methods and had two main objectives:

  1. Establish the prevalence of low-intake dehydration amongst older adults (≥65 years), in community and long-term care settings -  Systematic Review protocol
  2. Explore and understand how people living with dementia drink in a care home setting (D-DRINC Study A & B)



Our systematic review and meta-analysis is published open access in Clinical Nutrition, and you can read it here.

We presented preliminary findings from the systematic review at the Hydration for Health Conference 2022, and the British Society of Gerontology Conference 2022.
We also shared the findings on social media and reported the findings back to (patient and public engagement in research) and Alzheimer’s Research network.
We were also successful in being awarded some UEA Impact Funding to share the findings from the systematic review. Between June-July 2023, we met with older people, and health and social care professionals, to design 2 posters to raise awareness of the risk of dehydration to older people. We then displayed these posters in approximately 400 health and social care settings across Norfolk and Waveney, including Hospitals, GP Surgeries and Long-Term care settings. Copies of the final posters are available to download.


"Hot Water dispensers" by cbb4104 is licensed under CC BY 2.0
"Hot Water dispensers" by cbb4104 is licensed under CC BY 2.0

The D-DRINC Study (A)

An Inclusive approach to understand drinking, for people living with dementia in a care home.

In order to explore and understand how people living with dementia drink in care homes, we carried out an in-depth ethnographic case study within a care home in Norfolk.

Within the D-DRINC study, we observed and interviewed care home residents living with dementia and care staff (any role and any grade) for approximately 5 months, and recorded over 100 hours of observations. We were unable to consent, visiting health professionals and family caregivers/visitors to this study.

For more information about the study, please view the short research summary:

Short Research Summary


Study Documents

Please find here the participant information sheets, which will tell you about the D-DRINC study.

Recruitment for this study has now ended. We thank all the participants for their contributions and involvement within this study.


Findings from D-DRINC Study A and B have been shared within relevant peer-reviewed publications.

We presented preliminary findings from D-DRINC Study A at British Society of Gerontology Conference 2023, and findings from both D-DRINC Study A & B at Alzheimer Europe conference in Helsinki 2023.

We also shared findings on social media, patient and public involvement groups and to relevant social care organisations to disseminate widely to long-term care settings.


Research Team

Lead Researcher: Ellice Parkinson

Supervisory Team: Dr Diane Bunn, Dr Lee Hooper and Professor Fiona Poland

Systematic Review Team: Ellice Parkinson, Diane Bunn, Judith Fynn, Lee Hooper, Stephanie Howard Wilsher, Titilopemi Oladosu, Simone Roberts, Elien Van Hout.


Find out more about the work of the UEA Hydrate Group