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DEHYDRATION In Elderly --Hydration and Elderly Health Care

Human beings are about 60% water. We need to replace that water regularly; 6-8 glasses a day and more in hot weather. Most of us, if we’re honest, will own up to not drinking enough. Dehydration is more than being thirsty, however. It is severe and can be fatal. How about our elderly loved ones, who may not remember to drink enough, or who may have become cognitively or physically impaired? What are the effects of dehydration in elderly and what can be done to prevent it?




What is dehydration?


Dehydration simply means the body lacks fluids in its cells and blood vessels. Normally our body is constantly gaining fluids through the foods we eat and liquids we drink. At the same time, our body is also losing fluids through urination, perspiration, bowel movements and other metabolic functions.





The elderly are more prone to dehydration than anyone else because, for starters, they carry less water in their body naturally. As you age, the percentage of body mass by water decreases. This can make adapting to changes in temperature more difficult. Furthermore, your sense of thirst becomes less responsive as you age, meaning that by the time a senior is thirsty, it’s possible that they’ve already reached a point of dehydration.


Certain medical conditions can also become factors in dehydration in seniors. Dementia can lead a person to forget to consume enough fluids to battle dehydration, and dementia can even affect someone’s ability to swallow in extreme cases.


Drugs such as diuretics, laxatives, antipsychotics, and corticosteroids can increase the frequency of urination, leading to depletion of water and essential electrolytes. Many seniors who are prone to incontinence experience overcompensation to the amount of fluids they intake for fear of that leading to accidents. Thus, it’s important to remember that denying water or food under any instance when you need them can be critically dangerous and can lead to worse health effects than incontinence.




Effects of dehydration?

Dehydration in elderly can lead to:

  • delirium

  • seizures

  • urinary tract infections

  • kidney stones

  • more falls

  • longer wound healing times

  • hyperglycemia in diabetes patients

A hospital stay is also likely if an elderly person becomes dehydrated. The body can become so weakened by this that his or her lifespan can become shortened. This study (https://academic.oup.com/ageing/article/44/6/943/80322) showed that dehydration in elderly patients at admission are 6 times more likely to die in a hospital than those who aren’t. And another study (https://www.ncbi.nlm.nih.gov/pubmed/8059883) found that seniors admitted to hospital for dehydration had a 50% mortality rate in the following year. So, staying hydrated is vital for health and longevity.



What does dehydration look like?


Dehydration in elderly can cause delirium and confusion. As many people with dementia may suffer from these, also look for signs such as:

  • changes in urine color

  • skin dryness

  • rapid, weak pulse

  • dry mouth

  • inability to sweat



How much fluid should an elderly person drink a day?


According to the amount of water loss an average elderly person goes through a day, the recommended minimum water intake is 1700ml a day. There is also a formula which is used to calculate the required amount of water intake per day based on body weight – 1500ml is the minimum amount of water intake, plus 15 ml per kg to be added for the actual weight minus 20 kg. This formula can be used for underweight, overweight as well as normal weighted elders.




Tips to Help Elders Stay Hydrated


As a family caregiver, here are some steps you can take to ensure your senior family member is getting enough water throughout the day.

  • Offer fluids to your elder throughout the day. This should be done on a schedule.Make sure you provide your elder with a fluid that is appealing to them.

  • Always keep water in a place easily accessible to them. If your senior suffers from mobility problems, consider giving them a reacher or grabber tool to make it more convenient for them to reach out for water. Remind them to stay hydrated, especially when it is hot outside or just after physical exertion.

  • Some elders are reluctant to drink larger quantities of fluids, so offer smaller quantities throughout the day.

  • Consider including high water content fruits and vegetables in their diet, such as watermelons and lettuce. Try including soups with their meals, this is because nearly 20% of our fluid intake comes from our diet.

  • You need to identify any continence concerns that may be making your elder less inclined to consuming fluids. Try keeping a log of urination and incontinence episodes, as this can help you keep track of the problem.

  • Consider a timed toileting approach. This means keeping a regular schedule to help your elder go to the bathroom. This is especially helpful for elders suffering from memory issues and mobility problems.

  • Make sure to offer your elder extra fluids when it is hot outside and when they are ill.

  • Track your efforts in a journal. While this may take extra effort, track how much fluid the elder is getting in a day to make sure they are consuming more than the recommended fluid intake per day. If you notice the person prefers a certain drink, make a note of it and try including it more often in their diet.

  • Seniors should be careful not to spend time in the heat of the day, especially in the summer. Excess sweating can lead to quick dehydration. Staying in the shade often isn’t enough to keep you from sweating excessively on a very hot day. The safest times to be outdoors during the hot summer months are before 10 am and after 4 pm.

  • Using a moisturizer on your skin can help you stay hydrated as well, believe it or not. After all, your skin is where water is given off throughout the day. Use a water-based moisturizer on your skin to combat dry skin.




Electrolyte drinks for elderly


In summary, if you pay close attention to yourself or seniors around you, it can help massively in avoiding dehydration. Pay close attention to the signs of dehydration and ensure you’re taking in enough fluids through the methods stated above.


If you might need an increased amount of fluids due to an unusual amount of exercise or exposure to hotter temperatures for a long time, make sure to up the amount of fluids you intake even more, as these moments are when you’re most prone to encounter dehydration.


If you’re caring for a senior, offer them electrolyte drinks for elderly often and make sure that they’re drinks that they tend to enjoy. Don’t expect them to drink a large amount of liquid in one sitting, it’s much easier to intake your daily amount of water throughout the day in small amounts, around 8 ounces at a time. If the senior has trouble accessing fluids on their own, such as in a nursing home where fluid might have to be brought to them, try to find ways to make the staff more attentive to this or find ways to provide the senior with their own way to receive water, by stocking them with filled spill-proof cups or something similar.


Be aware of any medication that might be exacerbating dehydration. Awareness is key to prevention. And as always, if you’re experiencing any medical complication due to dehydration, please consult a medical professional, as their advice could be the difference between a disaster and perfect health.


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