Tips on Reducing Risk of Dehydration in Seniors
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    Dehydration is a common problem for seniors. Seniors have a higher risk of becoming dehydrated than younger adults. As we age, our bodies are unable to retain as much water. This means that seniors have lower fluid reserves in their bodies. Older adults may not recognize when they're dehydrated. This is because the thirst response dulls with age. Dehydration can also result from medical issues that are more common in seniors. These include the diuretic side effects of medication, diabetes, or diarrhea.

    Our kidneys rely on water intake to flush toxins from the blood. The kidneys are not able to work as efficiently without proper hydration. Our kidneys’ ability to filter blood declines with age. This means that seniors may experience dehydration symptoms more severely than younger adults.

    For seniors, even something small can cause severe dehydration like:

    • Diarrhea
    • Vomiting
    • Excessive sweating
    • Increased urination
    • Lack of mobility

    Other Risk Factors of Dehydration for Older Adults

    Woman outside in the heat doing yoga

    Certain risk factors increase the risk of dehydration. You should have a plan to prevent dehydration if you provide care for someone with risk factors.

    • Older age. Seniors over 85 are more likely to be hospitalized with dehydration than seniors between 65 and 74 years old.
    • Race. Black seniors are more likely to be hospitalized with dehydration than white seniors.
    • Medications. Many medications alter hydration status. It’s important to know possible side effects of all medications, and that your loved one has a proper medication management system. Discuss the side effects of medications with your loved one’s doctor.
    • Independence level. Some seniors are not able to keep themselves hydrated. This could be because they don’t remember to drink if they have cognitive impairment. It could also be because they are unable to move around easily and don’t drink water as often as they should. Nursing home studies show that independent seniors are at higher risk of dehydration. This may be because staff overestimates their ability to access water.
    • Chronic illness. Illnesses such as diabetes and kidney disease can lead to dehydration.
    • Acute illness. Diarrhea, vomiting, and fever can lead to dehydration. This means seniors are more at risk of becoming dehydrated when they’re ill.
    • Exercise and heat. Seniors who exercise or live in hot or humid environments can become dehydrated.

    16 Effects of Dehydration and Hydration on Seniors

    Hydration is important for keeping the body working properly. Hydration has an impact on all of the body’s systems. Proper hydration is associated with many positive outcomes, including:

    1. Fewer falls
    2. Lower constipation rates
    3. Less use of laxatives
    4. Better rehabilitation outcomes
    5. Lower risk of bladder cancer in men

    Dehydration can be dangerous. It can lead to things such as:

    1. Constipation
    2. Falls
    3. Medication toxicity
    4. Urinary tract infection (UTI)
    5. Respiratory infections
    6. Delirium
    7. Renal failure
    8. Seizure
    9. Electrolyte imbalance
    10. Hyperthermia
    11. Slower wound healing

    Some of the most serious complications of dehydration are:

    • Heat injury. Heat exhaustion and heat stroke lead to an increase in core body temperature. This can cause organ damage and may be life-threatening.
    • Urinary and kidney problems. The kidneys rely on water to function properly. Dehydration can lead to kidney damage and even acute kidney failure. Acute kidney failure is often reversible, but may require dialysis.
    • Seizures. Dehydration can lead to electrolyte imbalance. This can cause muscle cramps or, in severe cases, seizures.
    • Low blood volume shock. This can lead to a dangerous drop in blood pressure, which can be life-threatening.

    16 Warning Signs of Dehydration in Older Adults

    Dizzy man

    The effects of dehydration can be major, even life-threatening. Here are the warning signs of dehydration that you should look out for in a loved one. Pay special attention if they have any of the risk factors above.

    Signs of dehydration:

    1. Extreme thirst
    2. Fatigue
    3. Dizziness
    4. “Cottonmouth”, or dry tongue with thick saliva
    5. Dark-colored urine, or passing only a small amount during a trip to the bathroom
    6. Little or no sweating
    7. Cramping in arms and legs
    8. Headache
    9. Minimal or no tears when crying

    Signs of serious dehydration:

    1. Low blood pressure; pulse may be fast but weak
    2. Shaking and seizures
    3. Acute limb, back, and stomach muscle contractions and cramping
    4. Distended, bloated stomach
    5. Sunken eyes that are dry with few or no tears
    6. Wrinkly and wizened skin that has no flexibility
    7. Rapid breathing, faster than normal

    10 Tips to Keep Seniors Hydrated

    Water bottles

    Many older adults worry that drinking water will lead to incontinence. Remind your loved one that the benefits outweigh any potential drawbacks. With your loved one, come up with a plan together to ensure that they're hydrated that can include the following:

    1. If your loved one has a history of dehydration, increase their fluid intake over a period of a week, not all in one day.
    2. Encourage them to sip on water before they feel thirsty.
    3. Have your loved one drink water throughout the day. Have it on hand even when consuming another beverage such as milk or coffee.
    4. Offer a little bit of water at a time so your loved one is not overwhelmed.
    5. Include a glass of water at specific times of day, such as first thing in the morning and during meals.
    6. Avoid alcohol, and decrease caffeinated beverages due to their diuretic effect. Consider decaf coffee.
    7. Keep low-sugar sports drinks with electrolytes on hand.
    8. Frequently offer water to loved ones, especially those who may be physically limited.
    9. If your loved one lives alone, make sure they have an easy way to access water throughout the day.
    10. If your loved one lives in a facility, ask how the facility keeps residents hydrated. This is important if your loved one is independent, because they may not be offered water.

    By consistently drinking water over the course of the day, older adults can stay hydrated. This will ensure that they don’t suffer the negative effects of dehydration.

    When to Seek Medical Attention

    It is possible to manage mild dehydration at home, but sometimes it’s necessary to see a doctor. Doctors can treat dehydration and electrolyte imbalance. If your loved one is severely dehydrated, they may need IV fluids. Seek medical attention if you are worried, or if you see the following symptoms:

    • Diarrhea for 24 hours or more
    • Irritability or confusion
    • Inability to keep down fluids
    • Bloody or black stool
    • Very dark urine

    Some seniors have special fluid requirements. People with heart disease and renal disease may retain fluids. This means they may need to drink less water than others. Some seniors have fluid restrictions, so they must avoid drinking too much fluid. Fluid restriction is something that a physician will need to closely watch. Be sure to speak to your loved one’s physician before making any drastic changes to fluid intake.

    Resources:

    Dehydration - symptoms and causes

    Oral Hydration in Older Adults

    Heatstroke - symptoms

    Drink Up: Dehydration is Often an Overlooked Health Risk

    About the Author(s)

    Ashley Krollenbrock has been a caregiver for her mom for 10 years. She has her Masters of Public Health and JD with a concentration in Health Policy & Law. Ashley has done legal work for two state protection and advocacy agencies for people with disabilities. She is passionate about disability justice, aging justice, health equity, and aging in place. Ashley blogs at themillennialmatriarch.com, and her goal is to empower families to keep their aging loved ones at home by sharing her story and practical knowledge. Ashley lives in Oregon with her wife and mom, and when she’s not writing or caregiving she loves to travel, garden, and hike with her dogs.

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