Every Sip Counts
As we face increasingly hot summers, this year being one of the hottest, it is important to ensure we are being hydrated. When the temperature rises, unfortunately, so too does the risk for developing dehydration.
What is dehydration and what causes it?
Dehydration means the body doesn’t have as much fluid within the cells and blood vessels as it should.
Normally, the body constantly gains fluid through what we eat and drink, and loses fluid through urination, sweating, and other bodily functions. But if we keep losing more fluid than we take in, we can become dehydrated. If a person starts to become dehydrated, the body is designed to signal thirst to the brain. The kidneys are also supposed to start concentrating the urine, so that less water is lost that way.
Unfortunately, the body’s mechanisms that are meant to protect us from dehydration work less well as we age. Dehydration can be a problem for people of all ages, but is especially worrying for older adults. The elderly often have a reduced sense of thirst and dehydration is one of the most frequent causes of hospitalisation after age 65.
However, dehydration can also be fairly easily prevented. Look for the signs of dehydration and make sure your loved one has water available at all times, and you can go a long way toward preventing elderly dehydration. The signs and symptoms of dehydration in an elderly person can be virtually identical to those for dementia, which is why if not treated immediately it can lead to worsening conditions.
The most common signs and symptoms of dehydration include:
- Persistent fatigue and lethargy, irritable and tired
- Muscle weakness or cramps
- Difficulty walking
- Sunken eyes
- Dizziness (due to drop in blood pressure)
- Forgetfulness, confusion, disorientation
- Deep rapid breathing
- Increased heart rate (usually over 100 beats per minute)
- Dark-coloured urine. The more dehydrated a person is, the more concentrated their urine will be. In more severe cases, stool might be black or bloody.
Other less common signs and symptoms of dehydration can include:
- Excessive loss of fluid through vomiting, urinating, stools or sweating
- Poor intake of fluids, a feeling that they ‘can’t keep anything down’
- Dry or sticky mucous membranes in the mouth
- Skin that lacks its normal elasticity
- Decreased or absent urine output e.g. have not been to pass urine for more than 8 hours is severe dehydration
- Decreased tears
However the presence or absence of these physical signs are not reliable ways to detect dehydration as they can easily be caused by health problems, e.g. an infection other than dehydration. So if you are concerned about clinically significant dehydration — or about the symptoms above — blood tests results may be needed and a physical examination by a doctor.
Almost everyone gets about half their daily water requirement from solid foods and fruit and vegetable juices. However, the elderly often have a reduced sense of thirst and a reduced appetite.
Usually, a combination of the approaches below will improve fluid intake:
- Offer a favourite beverage the person likes.
- Offer small to moderate quantities of the beverage on schedule and encourage drinking water, milk or juice with every meal.
- Keep a glass or bottle of water within arm's reach, at all times. This is especially important for the elderly with mobility challenges.
- Encourage eating foods high in water.
- Make drinking a social thing, e.g. offer a ‘cup of tea’
- Avoid coffee, alcohol and high-protein drinks, especially in large quantities, because they have a diuretic effect which will exacerbate dehydration.
- Address continence issues. Encourage drinking more during the day and limit drinking before bed. Additionally, drinking small amounts of water throughout the day may help
Risk Factors for Elderly Dehydration
The risk factors you should recognise that heighten the risk for developing dehydration include:
- Chronic problems with urinary continence, which can make older adults reluctant to drink a lot of fluids due to fear of incontinence
- Memory problems, which can cause older adults to forget to drink often, or forget to ask others for something to drink
- Mobility problems, which can make it harder for older adults to get something to drink
- Living alone, because access to fluids often depends on the availability and attentiveness of family or friends who visit
- Swallowing difficulties, caused by stroke, Parkinson’s disease or dementia
- Diarrhoea, vomiting, fever, infection or excessive sweating can cause you to lose a lot of fluid and become dehydrated
- Having 5 or more chronic diseases
- Taking 5 or more prescription medications, esp. medication such as diuretics, which are often prescribed to treat high blood pressure or heart failure
- Hot weather always increases the risk of dehydration.
What are the consequences of dehydration?
The consequences depend on how severe the dehydration is, and perhaps also on how long the dehydration has been going on.
In the short-term, dehydration can cause the physical symptoms listed above. Especially in older adults, weakness and dizziness can provoke falls. And in people with Alzheimer’s or other forms of dementia, even mild dehydration can cause noticeable worsening in confusion or thinking abilities.
It is plausible that dehydration increases the risk of urinary tract infections (UTIs) as there has been found to be a link between fluid intake and urinary system disorders. Dehydration also often causes the kidneys to work less well, increase the risk of kidney stones and in severe cases may even cause acute kidney failure.
Sometimes, dehydration can get more severe. If you or your loved one has had diarrhoea for more than 24 hours, has black or bloody stool, has not been able to pass urine, or has trouble keeping fluids down, it may be a good time to call the emergency services.
How we can help
At AevaCare, if you are worried that when you are not around, your loved one is not having drinking or eating enough to fulfil their hydration and nutritional needs, we are able to pop in, help with meal preparation and ensure fluids are available at all times. For more complex needs, we would record and be able to track the fluid and meals that your loved one has drunk or eaten.