While malnutrition and hospital food are what we often see in the news, dehydration is also an alarming concern for the elderly. Preventable dehydration, whether in hospitals or residential settings, can be a sign of poor health care. And while it can be preventable, it is still common, especially among the elderly.
Indeed, when you improve hydration, you can also improve one’s well-being. You can bring better service to patients, prevent illness, and reduce the use of medications.
Thus, in this article, you will learn more about dehydration among the elderly. We will discuss the signs and symptoms, risk factors, and effects. We will introduce the treatment methods and tips to prevent dehydration in the long run.
What is Dehydration?
Risk Factors of Dehydration
The elderly are susceptible to dehydration because of their 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 strong as other age groups.
Second, there are physical changes brought about by age, which 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 the regulation of body fluids. However, their function can deteriorate as one ages. After that, one’s hormonal response to dehydration can be weakened.
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 inability and poor access to fluids. In the health care settings, this can be linked to inadequate training of the staff and lack of education regarding the importance of hydration.
The risk factors of dehydration are the following:
- Decreased thirst
- Diarrhea, acute disease, constipation, and vomiting
- Impaired functional status
- Inadequate number of trained staff to assist the elderly
- 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 can feel tired all the time. When we talk about mental functions, one can have problems with attention, memory, concentration, and reaction time. Some of the complications due to dehydration can include weakness, low blood pressure, increased risk of falling, and dizziness.
If the elderly are dehydrated, they can experience skin problems and pressure sores.
Indeed, water can help make the kidney and urinary tract healthy. When you decrease the fluid intake, the urinary tract infection will increase. Inadequate hydration is one of the causes of experiencing kidney problems.
Moreover, dehydration is the cause of constipation. Drinking water can increase stool frequency. This can also enhance the effects of fiber in the body. Many people cut their fluid intake to avoid going to the toilet often. This is true, especially during nighttime. But restriction of drinking water will make one suffer from urinary problems in the long run.
Causes of Dehydration
Dehydration for older adults is common due to several reasons:
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 being thirsty becomes lesser. Moreover, there are those elderly patients who have a hard time getting up from their bed to have a drink whenever they are 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.
Diarrhea and vomiting can make the elderly dehydrated. If you think your elderly relative is dehydrated, you can check his skin turgor. Pull the skin on the back of his hand for a few seconds. If the skin does not return to normal, then your elderly folk is dehydrated.
Drinking 8 Glasses of Water Each Day
Each person has its 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 is contrary to the common belief that each person must drink eight glasses of water each day. No specific study can back up this claim. People had misinterpreted it to be 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 cup 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 monitor first your body weight. Weigh yourself every morning to do this. If you have lost around two pounds or more from the previous day, you are probably dehydrated. This is also true if you have a headache or thirsty.
If you lose around 2% of your total body weight, then you are experiencing mild dehydration. Meanwhile, you can experience severe dehydration if you lose 4% of your total body weight. Losing weight due to dehydration is not good since it leads to health problems.
Remember that mild dehydration can affect the body. This is true if you have renal or cardiac problems. On the other hand, if you are experiencing severe dehydration, it can put a great strain on your heart. Think of a pump with fewer fluids. This can be one of the main problems if you are dehydrated.
Experts agree that you always don’t have to rely on the scales to measure your hydration levels. Sometimes, the accuracy is poor, and can’t determine when one needs to be hydrated.
The signs of dehydration in young people are not visible to the elderly. For example, if a young patient is dehydrated, he 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 make sure that your loved one doesn’t experience dehydration, see that he consumes adequate fluids each day. Let him eat healthy foods with water. Examples of these are soups and fruits and vegetables. Then check if the urine color is light. If the urine is dark, then it is a sign of dehydration.
Educate your old loved ones on the importance of drinking water even if they are not thirsty. You can keep a bottle of water near their bed. Put it beside their favorite chair, especially if they have mobility issues.
Just like any other health issue, prevention is the solution. See to it that your loved ones are hydrated. This is easier than treating the problem later.
Steps for Nursing Facilities
In a study, it has been found out that preventing dehydration in health care 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, see that they have a hydration program in place. Check if they are assisting the patients in drinking their beverages, offer a variety of drinks, and provide drinks at mealtimes.
You can also ask if they are monitoring the weight of the residents. Ask if they are assessing the patients’ mental and physical condition from time to time. If your loved one takes laxatives or diuretics, which causes dehydration, you can talk to the doctor about switching the medication.
Here are other strategies to include:
- For the nursing facilities, the administration must train the staff to know how important hydration.
- Plan for an individualized liquid intake goal
- Give each patient their preferred fluids
- Make the fluids available all the time
- See to it that the water is fresh and palatable. You can add ice cubes, a slice of lemon, or orange to the water.
- Offer water or any drinks throughout the day.
- Give fluids in between activities or medications. Do this for routine events like physiotherapy.
- Give a variety of cold and hot drinks.
- Provide assistance and special cups if needed
- Give a full glass of water when there are medications
One strategy to try to increase the intake of water is to provide a happy hour. Ask relatives and friends to visit the nursing home. Let them offer water to the patients. Also, encourage the patients 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. They must understand how to maintain hydration levels. Moreover, they must recognize the signs and symptoms of hydration.
In a nutshell, it can be more difficult to be hydrated as we age. The signs of dehydration are milder, and we might not feel thirsty, unlike others. Indeed, hydration plays an important role in elderly care.
Those who drink more water can have healthy physical and mental abilities. It can improve the endurance level, speed up the recovery process, lower the heart rate, and increase physical activities.
Moreover, those who drink more liquid can have better moods versus those who don’t — as such, staying hydrated can be an essential element of maintaining your overall health.
Finally, when we get old, appetite and other activity levels tend to decrease. This makes us become at risk of being sick. When we drink more fluid, our body can be resilient from developing different illnesses.
Indeed, we must be aware of what our elderly loved ones drink. This is because not all liquids have the same health effects on the body. For example, alcohol is not an effective means to rehydrate. Meanwhile, fruit juices can have high sugar content, which can trigger acidity. As such, these are not the main liquid to take throughout the entire day.
It can be difficult to encourage older adults to drink enough. But you can try a variety of ways to increase their chance of drinking the fluids. You must ensure that there is a variety of drinks that are easily accessible to them. See to it that they are taking enough fruits and vegetables daily. These foods contain water. Cucumber, tomatoes, and watermelon are some of the good options that you can try.