Dehydration is a common problem in the elderly, and can be brought on by diuretic medications, excessive sweating, diarrhea, and insufficient fluid intake. To complicate matters, as we age, our ability to detect thirst declines, and the body has more difficulty regulating its fluid levels. Experts estimate that 30% of LTC residents are dehydrated and almost half of seniors admitted through hospital ERs show signs of dehydration; the problem is even more common during the hot summer months.
Signs and Symptoms
Watch for a decrease in urine output or dark or deep yellow urine possibly accompanied by cramping in limbs, weakness, inability to sweat or produce tears, confusion, headaches, sunken eyes, and irritability. All of these are earlier indications of dehydration. Left untreated, it can lead to low blood pressure, rapid but weak pulse, severe cramping, convulsions and loss of consciousness. Loss of skin elasticity is a tell tale sign of serious dehydration; if you gently pinch the skin on the back of the hand and it doesn’t immediately return to normal, it’s time to contact the doctor.
Prevention is the Key
To avoid getting to that point, it’s important to keep your loved one hydrated, which can be easier said than done. Taste, lack of appetite, loss of thirst recognition, and incontinence fears can all contribute to this struggle. Here are 6 tips to help.
- Variety is the spice of life, or so they say, and this is true of fluid consumption as well. When you give someone plain water or the same kind of juice every day of the week, they are naturally going to get bored. Shake things up and make water more palatable. Vary juices and try infused water (lemon and cucumber are great choices, but any favorite fruit will add a nice light flavor to drinking water).
- Choose fruits & vegetables that are high in water content. Fruits coming in at the top of that list are watermelon and strawberries at 92%, followed closely by grapefruit and cantaloupe. Oranges, blueberries, raspberries, pineapple and peaches are also good choices, with bananas having the lowest water content. The winning vegetable is cucumber at 96%, and rounding out that list are zucchini, celery, tomatoes, spinach, peppers, eggplant, cauliflower, and broccoli.
- Provide reminders and devise a system to track fluid intake. Whether you use a checklist or store fluids in marked containers, the key is keeping it simple so that it doesn’t require a lot of effort.
- Make it convenient. Keep cold drinks near your loved one’s favorite spot. If they spend most of their time upstairs, they are probably not going to go to the effort of walking down the stairs to get a drink – even if they are thirsty. Consider a mini-fridge for rooms on a different level than the kitchen.
- Reduce incontinence worries by ensuring the heaviest fluid intake is earlier in the day rather than close to bedtime. Consider using disposable undergarments; new thinner pull-on styles make them feel more like traditional underwear.
- Avoid diuretics like caffeinated drinks, and remember that some medications cause water to move through the body at a faster rate. Take this into consideration when determining appropriate level of daily fluid intake.
At the first sign of dehydration, offer a sports drink to help boost water and electrolyte levels in the body. It’s also a good idea to call the doctor so that he or she can assess the situation. The key is recognizing early red flags and taking immediate action; otherwise, the situation can worsen very quickly increasing chances that medical intervention will be needed.