Source: theupsidetoaging.com byFiona S Giles
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 causes dehydration?
As we get older, the water content in our body decreases, meaning we need to drink more often. Older kidneys are also less efficient, so the urine contains more water. However, the sensation of thirst also decreases with age, creating a catch-22 situation. We need to drink more but are less likely to feel thirsty.
Medications can alter the balance of salt and water in our bodies, meaning we require more water. Blood pressure medications, for example, can cause more frequent urination. Other medications may cause loose stools or increased sweating. Vomiting and diarrhea also cause us to lose fluids rapidly. This all causes dehydration in elderly.
What are the effects of dehydration?
Dehydration in elderly can lead to:
- 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
Why is my loved one drinking less?
Before you or even as you offer more fluids, take time to consider why your loved one is drinking less.
He or she could be nauseous, or in pain, particularly in the stomach or mouth areas. Check the mouth for sores, caries or redness and take them to a dentist if you see anything amiss.
The cause could be depression or anxiety. Any changes to their routine, location, who helps them or what they are served can upset a patient enough to refuse food and water.
A person with dementia or Alzheimers may not recognize a drink or what to do with it. You may need to regularly remind them by showing them what to do, drinking with them, or wetting their lips with the drink.
For later stages of dementia, it often becomes harder to swallow, which can lead to dribbling and choking. In this case, you may need to offer fluids even more often. If this is the case, you might consider discussing new hydration options with your doctor.
How can I encourage my loved one to drink more?
Once you have eliminated and/or addressed any medical causes, here are some ideas to encourage an elderly person to drink more.
- Encourage your loved one to drink small sips more often.
- Keep drinks where they can be seen and easily reached.
- Offer a variety of flavors. Squash, flavored waters, herbal teas, and milk might taste more appealing.
- Add soda water to drinks to make them bubbly.
- Smoothies, ice blocks, and sports drinks are all suitable alternatives to water. You can make your own ice blocks with juice if you are worried about the sugar content.
- Offer broth, Milo, Bovril, miso soup and similar warm drinks.
- Coffee and tea are also good in moderation.
- Experiment with different temperatures. One person may love ice cold water, while another may prefer room temperature.
- Too many choices can be confusing. Try offering a choice of only 2 options each time you offer a drink. (e.g., “Would you like Milo or tea?)
Many foods contain water. These foods have high water content and will aid with hydration:
- melon and watermelon
- oranges, mandarins, and grapefruit
- stonefruit such as peaches
- cottage cheese,
- jelly (or Jell-O)
- ice cream
Is there anything I can buy to aid hydration in the elderly?
The best first option is a non-spill cup. These aid independent drinking in anyone with tremors, shakes or a weak grip, or who spends a lot of time reclining.
You can purchase one-way straws to help with weak suction or shortness of breath. If you don’t get liquid into your mouth on the first try, the liquid will stay put while you take a breath and continue rising while you suck again, until it reaches your mouth.
You could even buy a clever gizmo called a Ulla. It can be attached to a glass or jug and blinks brightly every 40 minutes or so to remind the owner to drink.
What are the benefits of staying hydrated?
- More independent life: With fewer falls, fainting or confused episodes, your loved one can remain in their own home or care home for longer and spend less time in the hospital.
- More comfortable life: Higher volumes of fluid means less constipation and fewer UTIs.
- Longer life: Dehydration is fatal alone if undiagnosed. It can also cause other conditions to be more serious, such as diabetes and wound healing.
- If your loved one does need hospitalization, for any reason, being hydrated means a faster recovery time, fewer pressure ulcers and a better chance of not coming back to the hospital soon.
- Staying well-hydrated means a happier, healthier life!
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