Dehydration in Older Adults

Getting enough fluids helps keep seniors active and healthy. Adequate hydration is one of the most important aspects of healthy nutrition. It can provide energy so that people can run errands and get exercise. Unfortunately, hydration issues are common for older adults. This struggle is the result of both natural biological processes through aging, physiological characteristics, and environmental factors. Seniors and their loved ones should understand the facts about dehydration so that they can put preventative measures in place.

1. What is Dehydration in older adults?

Anyone of any age can experience dehydration, which is a lack of an appropriate amount of fluids. Older adults especially can suffer the impacts of dehydration. Given the health problems that many older adults face, medications, and increased need for fluid, dehydration can happen to seniors without them noticing. As time goes on, the problem worsens and can lead to severe side effects for seniors.

1.1 Is dehydration common in seniors?

Dehydration is the top issue for seniors when it comes to potential fluid problems. Research posits that about 40 percent of seniors experience consistent dehydration.

1.2 Mild vs moderate vs severe dehydration: What is the difference?

Doctors classify dehydration into different categories to know what treatment plan to follow. These are the differences between the types of dehydration.

a/ Mild Dehydration

Mild dehydration usually presents little to no changes in the physical state of the patient and includes the following classification components.

• Normal presentation in moistness of skin and hair
• Normal skin color
• Largely unimpacted mental state
• Normal vital signs
• Less than 5 percent weight loss due to water weight
• Increased fatigue with exertional exercise
• Can cause more significant issues in some patients with underlined kidney disease or those whom medications require normal kidney function
• Can increase risk for urinary track infection (UTI)
• Can cause light headedness (which worsens as the dehydration becomes more severe)

b/ Moderate Dehydration

Moderate dehydration presents more physical and mental health risks within its classification components.

• Increased heart rate
• Increased breathing rate
• Changes in mood
• Increased tiredness
• Dry appearing skin
• Slightly sunken eyes
• Water-weight loss between 5 percent and 9 percent

c/ Severe Dehydration

With severe dehydration, the body can go into shock and result in death without emergency treatment. This classification has more severe components.

• Low blood pressure
• Erratic breathing
• Increased heart rate
• Cold hands and feet
• Very sunken eyes
• Changes in skin color and presentation
• Dry looking skin
• Loss of consciousness
• Water-weight loss of ten percent or more.

2.What are the signs of dehydration in older adults?

There are many different signs of dehydration in older adults, especially as dehydration becomes severe. The effects of dehydration in seniors begin as subtle but can progress quickly. The signs of dehydration change based on the severity and the type of impact.

2.1. What are the early signs of dehydration in older adults?

At the beginning of dehydration, people may not notice many, if any, symptoms. Early indicators can include a change to a darker color of urine, tiredness, infrequent urination, and dry mouth. These are the earliest symptoms that people need to start drinking more water.

2.2 What are the signs of dehydration in older adults?

As dehydration becomes more severe, people find the signs of dehydration more noticeable. Seniors become more lethargic as dehydration worsens. They also experience mood changes, including agitation.

People experience lightheadedness and may feel faint. Seniors may complain of feeling sleepy or falling asleep at unusual times.

A physical examination may reveal dry mouth, dry underarms and poor skin turgor. Skin turgor is how fast the skin rebound when pinched. The skin should normally rebound very quickly.

2.3 What are the mental effects of dehydration in seniors?

Dehydration commonly can cause lethargy (lack of energy). It can also cause or mimic depression. In sever cases, it can also cause a mental condition known as delirium, which produces severe confusion, disorientation or hallucinations. The symptoms of delirium mimic those of dementia, but the symptoms are a result of dehydration or some other acute medical process.

2.4 What are the physical signs of dehydration in seniors?

The physical signs of dehydration in seniors include visible symptoms on the body. Unfortunately, there are not many that people may notice. These are the primary physical signs of dehydration in seniors:

• Sunken eyes;
• Dry-looking skin or hair; and,
• Lack of tears or sweat.
• Poor skin turgor

2.5 What are the risks that may result from dehydration in older adults?

Dehydration causes risks, especially for seniors. These are some of the most important risks for seniors from dehydration:

• Increased risk of falling and becoming injured;
• Organ failure, especially kidneys;
• Low blood pressure;
• Increases medication side effects
• Decreased mood
• Decreased cognition
• Death

3. What causes dehydration in older adults?

Seniors experience comorbidities and are particularly vulnerable when it comes to the effects of dehydration. Understanding the risk factors for dehydration in older adults can alert people to the increased danger of possible dehydration.

What are the risk factors that may contribute to dehydration?

These are some of the most important factors that increase the risk of dehydration in seniors.

1. Remembering to drink: Seniors may experience difficulty remembering to drink water throughout the day. Older adults experience a natural decline in thirst indicators as they age, plus neurological conditions can exacerbate memory issues or an urge to drink water.
2. Medication: Some medications produce an effect that leads to the loss of fluids. These can include diuretics or laxatives, which increase the expulsion of fluids from the body.
3. Certain disorders: Some disorders, such as diabetes and kidney disease, impact the ability to retain fluids, which increases the risk of dehydration.
4. Acute illness: Some short-term illnesses, such as colds and flu, put seniors at greater risk of dehydration. Sore throats and congestion can make it more difficult to consume liquids.
5. Increased activity levels: It is important for seniors to stay active, but increased activity also increases the fluids that they need. Sweating and increased fluid needs by the body for physical activity can put seniors at greater risk of dehydration.
6. Natural deterioration in thirst: As everyone ages, they have a reduction in their ability to feel thirst and hunger. Especially since people get some of their fluid intakes through food, a reduction in eating and drinking can put seniors at a greater risk.

4. How to avoid dehydration in older adults?

The best way to avoid dehydration in older adults is to make sure they get enough fluids. Most often, this means drinking enough water. Generally, healthy people should drink about 32 ounces to 48 ounces of water per day. Precise needs, however, can vary between individuals. Those with certain conditions may need more or less water. Active seniors may need more water. Consulting with a doctor is a good idea, especially for seniors, to figure out exactly what someone’s individual needs may be. A good rule of thumb is to drink of a glass of water with each meal. Also, if you have any illness that could put you at risk of dehydration (such as stomach flu with diarrhea/vomiting or upper viral syndrome with decreased appetite) you should talk to your doctor about your diuretic medications.

4.1 What can seniors drink to stay hydrated?

While water is the simplest way for anyone to reach their hydration goals, not everyone finds the taste of water enjoyable. For other ideas to help seniors reach the number of fluids they need every day, people can try these drink choices:

• Pedialyte;
• Crystal Light;
• Fruit juice with low sugar;
• Vegetable juice;
• Flavored water;
• Milk;
• Herbal tea;
• Coconut water;
• Sports drinks; and,
• Watermelon water.

Seniors should make sure that any of the options that they choose are not high in sugar or caffeine, as those can have a dehydrating effect. Remember that these options can help prevent dehydration by maintaining proper fluid levels. Once seniors experience dehydration, they need to see a doctor who may prescribe an oral hydrating solution, IV, or other treatment to restore proper hydration levels.

4.2 Tips for Caregivers to help their senior loved ones stay hydrated

Caregivers are essential to keep up with the hydration needs of older adults. These are some of the ways that caregivers can help.

1. Encouragement: Encouraging seniors helps them stay hydrated by reminding them and giving them positive reinforcement. Caregivers can even find water bottles and glasses with encouraging words at different water lines.
2. Set a schedule: Caregivers can make it easy for seniors to incorporate more hydration into their routine by making it a part of the schedule. A glass of water in bed could be the task before they start the morning. They could have a regular afternoon herbal tea. Finding ways to coordinate hydration is key. Be mindful to have at least some fluid with every meal or snack.
3. Increase accessibility: Caregivers can make the act of getting water easier by making water more accessible. Insulated water bottles can keep ice and drinks cold for many hours. Seniors or their caregivers can fill one in the morning to keep with them throughout the day and bring it with them wherever they go.
4. Choose water-rich foods: It is easier to meet fluid goals by relying on both food and drinks to provide hydration. A diet rich in fruits and vegetables is not only healthy for seniors in general, but it also makes it easy for seniors to meet their fluid needs without even realizing it.
5. Avoid dehydrating liquids: Some liquids create a dehydrating effect, rather than a hydrating one. Caregivers should limit the availability of these liquids. Coffee, caffeinated teas, alcohol, and sugary drinks can prevent seniors from getting the hydration they need.
6. Watch for sun exposure: Prolonged to exposure to the sun can create dehydrating. Getting outdoors helps keep seniors active and healthy, but caregivers should make sure to increase water intake during and after going outside.
7. Understand health impacts: For caregivers to know how much water their client or patient should have, they need to know the medicines they take and any illnesses they have that may alter the amount of water they need. Caregivers can examine medication labels and pamphlets and talk to the family about any medical conditions.
8. Make it flavorful: Some people simply do not like the taste of water. There are plenty of ways to add flavor to water to make it more interesting. Caregivers can fill a pitcher of ice water and place a few slices of cucumbers, lemons, or strawberries inside for a more inventive taste. Caregivers can also find plenty of concentrates to add to water available on the market to turn water flavorful at home.
9. Keep a log: Caregivers can get seniors to take part in their own hydration needs by keeping a log or chart. Create a log with each day of the week and the senior can put a checkmark on each day that they meet their water goals. Not only does this help them maintain their independence, but it also gets them to drink more fluids.
10. Home Care: When family caregivers are not available to ensure their senior loved ones stay hydrated, they may consider getting help from a home care provider to make sure their loved ones drink enough water.

5. FAQs about Hydration in Seniors

5.1 Can dehydration cause confusion?

Dehydration can cause confusion or delirium. Seniors may show symptoms of confusion, distraction, and irritability. While these symptoms are similar to dementia, the symptoms of delirium go away after effective dehydration treatment.

5.2 Can dehydration cause hallucinations?

Severe dehydration can cause hallucinations. Inflammation, a reduction of blood flow to the brain as a result of dehydration, and fever can cause a myriad of psychological problems typically associated with other disorders.

5.3 Can dehydration cause dizziness?

Dizziness is one of the most common symptoms of mild to moderate dehydration. This may be one of the first significant indicators. Dizziness is especially dangerous for seniors who may experience an increased chance of a fall.

5.4 How does dehydration affect the skin?

Dehydration affects the skin by making it appear rough and dry or may cause poor skin turgor . The reduction in water in the body impacts every organ, including the skin.

6. Key Takeaways

There are main points to remember about dehydration in older adults:

1. Dehydration is a common issue for seniors as they age.
2. Certain medications, disorders, and a lack of thirst or hunger increase the risk of dehydration.
3. Common symptoms of dehydration include thirst, dizziness, lethargy, and mental distortion.
4. While it varies individually, seniors should strive for about 32 ounces to 48 ounces of water every day.
5. Eating fruits and vegetables along with drinking low-sugar and low-sodium fluids can maintain a healthy level of hydration.
6. Caregivers play a key role in motiving seniors to stay hydrated. They can create incentives and make adjustments to routines to make staying hydrated easier.
7. Anyone experiencing symptoms of dehydration should see a doctor immediately. If someone has symptoms of delirium, fever, black or red stool, seizures, or changes to vital signs, they or their caregiver should call 9-1-1.