While malnutrition and hospital food are often discussed in the news, dehydration is also an alarming concern for the elderly.
Preventable dehydration can indicate poor health care in hospitals or residential settings. While preventable, it is still common, especially among the elderly.
Indeed, improving hydration can also improve one’s well-being. It can improve patient care, prevent illness, and reduce medication use.
Thus, this article will teach you more about dehydration in the elderly. We will discuss the signs and symptoms, risk factors, and effects. We will also introduce treatment methods and tips for preventing dehydration in the long run.
What is Dehydration?
Risk Factors of Dehydration
The elderly are susceptible to dehydration because of the physiological changes in the aging process. However, this can be complicated due to various illnesses and physical and mental frailty. Overall, these factors can increase one’s risk of being dehydrated.
For medical professionals, the signs of dehydration can be challenging to detect among patients. First, the elderly don’t feel thirst as strongly as other age groups.
Second, physical changes brought about by age can reduce his sensation of thirst. This is prevalent for people with Alzheimer’s disease or those who suffer from a stroke. As such, thirst for the elderly must not be relied on to indicate dehydration.
Another risk factor is reduced renal function. Indeed, the kidney plays an important role in regulating body fluids. However, kidney function can deteriorate as one ages, weakening one’s hormonal response to dehydration.
Indeed, dehydration is common for people who have a functional disability and cognitive impairment. Diabetes, dementia, and swallowing difficulties are common for the elderly. These can be associated with poor hydration.
Moreover, one is likely to experience dehydration due to medications, including laxatives and diuretics. Most importantly, incontinence can lead to dehydration since the elderly tend to limit their water intake.
It must be understood that inadequate fluid intake is a major factor in dehydration. If you have an oral pool habit of fluid intake, it can lead to an inability to access fluids.
This can be linked to inadequate staff training and a lack of education about the importance of hydration in healthcare settings.
The risk factors of dehydration are the following:
- Decreased thirst
- Depression
- Diarrhea, acute disease, constipation, and vomiting
- Impaired functional status
- Inadequate number of trained staff to assist the elderly
- Incontinence
- Living in long-term care
- Multiple medications like diuretics
- Needs assistance in the intake of food and liquids
- Old age
Effects of Dehydration
Dehydration can lead to poor health. This can also cause hospitalization and even death. In a recent study, there is a two-fold increase in mortality among stroke patients.
Mild dehydration can affect mental performance. One may always feel tired, and mental functions such as attention, memory, concentration, and reaction time may be affected. Some complications of dehydration include weakness, low blood pressure, an increased risk of falling, and dizziness.
If the elderly are dehydrated, they can experience skin problems and pressure sores.
Indeed, water can help keep the kidneys and urinary tract healthy. When fluid intake decreases, urinary tract infections increase. Inadequate hydration is one cause of kidney problems.
Moreover, dehydration causes constipation. Drinking water can increase stool frequency and enhance the effects of fiber in the body. Many people cut their fluid intake to avoid frequent toilet trips, especially at night.
However, drinking water restriction can lead to urinary problems in the long run.
Causes of Dehydration
Dehydration for older adults is common due to several reasons:
Medications
It’s common for older adults to be under various medications. Some medications are diuretics. However, some medications can make the elderly sweat more.
Decreased Feeling of Being Thirsty
As one ages, the feeling of thirst diminishes. Moreover, some elderly patients have difficulty getting up from their beds to drink whenever thirsty. Sometimes, they rely on their caretakers, who can’t tell when they need to have a drink.
Kidney Function Decreases
We lose our kidney function when we age. With this, it can function less to conserve fluid. This ability can start when we hit the age of 50. It becomes more noticeable and acute when reaching the age of 70.
Illness
Diarrhea and vomiting can dehydrate the elderly. If you think your elderly relative is dehydrated, you can check his skin turgor by pulling the skin on the back of his hand for a few seconds. If the skin does not return to normal, your elderly relative is dehydrated.
Drinking 8 Glasses of Water Each Day
Each person has a normal state of body liquid, which varies according to one’s weight. When you are below the normal state, you are dehydrated. If it’s above the normal state, then it's hyperhydration.
Indeed, the normal hydration level can differ from one person to another. This contradicts the common belief that everyone must drink eight glasses of water daily.
No specific study can support this claim. People misinterpreted it as a liquid, which must be water.
Moreover, a person’s diet can affect hydration levels, too. Soups, fruits, and vegetables are water-based. Every single day, we can get water from our food. We drink what we eat, no matter where we go.
It is also wrong to assume that drinking caffeinated drinks can cause dehydration. The amount of caffeine in tea or cups is small.
Meanwhile, this drink is composed mostly of water. Thus, it will still hydrate you to some extent. This is also true for beer and other alcoholic drinks. However, there is a point wherein alcohol and caffeine can kick in. Thus, drinking moderately is always the answer.
As a general rule, big people must drink more water. This is also true for athletes and workers who perspire heavily.
How to Track Hydration Level
To determine your hydration levels, you can first monitor your body weight. Weigh yourself every morning. You are probably dehydrated if you lost two or more pounds the previous day. This is also true if you have a headache or are thirsty.
If you lose around 2% of your total body weight, you will experience mild dehydration. Conversely, if you lose 4% of your total body weight, you will experience severe dehydration. Losing weight due to dehydration is bad because it leads to health problems.
Remember that mild dehydration can affect the body, especially if you have renal or cardiac problems. Severe dehydration, on the other hand, can strain your heart greatly. Think of a pump with fewer fluids. This can be one of the main problems if you are dehydrated.
Experts agree you should never rely on scales to measure your hydration levels. Scales can sometimes be inaccurate, and you cannot determine when to be hydrated.
The signs of dehydration in young people are not visible to the elderly. For example, if dehydrated, a young patient can have sagging or wrinkling skin. However, this is not noticeable, especially for the elderly.
Due to the interval in diagnosis, dehydration is one of the causes of hospitalization. If this is not given attention immediately, it can be life-threatening.
How to Prevent Dehydration in the Elderly
To prevent dehydration, ensure your loved one consumes adequate fluids daily. Let him eat healthy foods with water, such as soups, fruits, and vegetables. Then, check if his urine is light. Dark urine is a sign of dehydration.
Educate your elderly loved ones on the importance of drinking water even if they are not thirsty. You can keep a bottle of water near their bed or beside their favorite chair, especially if they have mobility issues.
Like any other health issue, prevention is the solution. Make sure your loved ones are hydrated. This is easier than treating the problem later.
Steps for Nursing Facilities
In a study, it has been found that preventing dehydration in healthcare facilities depends on various factors. Increasing assistance and the choice and availability of drinks can be helpful in the long run.
If your old relative or friend is in a nursing facility, check that it has a hydration program. Check if the staff assists the patients in drinking their beverages, offers a variety of drinks, and provides drinks at mealtimes.
You can also ask if they monitor the residents' weight and periodically assess their mental and physical condition. If your loved one takes laxatives or diuretics, which cause dehydration, you can talk to the doctor about switching the medication.
Here are other strategies to include:
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For the nursing facilities, the administration must train the staff to know how important hydration.
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Plan for an individualized liquid intake goal
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Give each patient their preferred fluids
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Make the fluids available all the time
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Make sure the water is fresh and palatable. Add ice cubes and a lemon or an orange slice to it.
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Offer water or any drinks throughout the day.
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Give fluids in between activities or medications. Do this for routine events like physiotherapy.
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Give a variety of cold and hot drinks.
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Provide assistance and special cups if needed
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Give a full glass of water when there are medications
One strategy to increase water intake is to provide a happy hour. Ask relatives and friends to visit the nursing home.
Let them offer the patients water. Also, encourage them to eat wet foods like jelly, yogurt, pureed fruit, soup, and custard.
Care staff must be aware of the causes of dehydration, especially in older patients, and understand how to maintain hydration levels.
Moreover, they must recognize the signs and symptoms of hydration.
Conclusion
In summary, staying hydrated can be more difficult as we age. The signs of dehydration are milder; unlike others, we might not feel thirsty. Indeed, hydration plays an important role in elderly care.
Drinking more water can improve physical and mental health. It can also improve endurance, speed recovery, lower heart rate, and increase physical activity.
Moreover, those who drink more liquid can have better moods than those who don’t — as such, staying hydrated can be essential to maintaining your overall health.
Finally, appetite and other activity levels tend to decrease when we get old. This puts us at risk of being sick. When we drink more fluid, our bodies can be resilient from developing different illnesses.
Indeed, we must be aware of what our elderly loved ones drink. Not all liquids have the same health effects on the body. For example, alcohol is not an effective means of rehydrating.
Meanwhile, fruit juices can have high sugar content, which can trigger acidity. As such, these are not the main liquids to take throughout the day.
It can be difficult to encourage older adults to drink enough fluids, but you can try various methods to increase their chances of doing so. One method is to ensure that a variety of drinks are easily accessible to them.
Also, ensure they eat enough fruits and vegetables daily, as these foods contain water. Cucumbers, tomatoes, and watermelon are good options.
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