Not getting enough fluids can become problematic, not only in the summer but all year round. Becoming slightly dehydrated can have an effect on mood, memory, and attention, according to research conducted at UK Swansea University. Dehydration can pose serious health problems for everyone, but especially for older adults and persons with dementia.
As with all medical advice, please consult your physician for your individual situation. The information here is for educational purposes only.
What is dehydration?
Dehydration happens when your body does not have the amount of water or fluids it needs in order to carry out its normal functions. Fluids are lost when we breathe, sweat, urinate, have bowel movements, and vomit.
Water makes up about two-thirds of our bodies. It lubricates our joints and eyes, it facilitates proper digestion, it keeps our skin healthy. Water lessens the risk of constipation, as it helps move food waste through our intestines and ultimately out of our body. Dehydration may lead to loss of muscle tone, slow metabolism, increased toxicity, chronic constipation, and in extreme cases to organ failure. Inadequate fluid or water can also cause kidney stones, while adding stress to the kidney organ. Severe dehydration is a medical emergency and needs to be treated immediately.
Aging and dehydration
Aging causes people to lose their sense of thirst and their kidney function is often somewhat diminished. “From a physiological standpoint, as aging occurs, the water content of our bodies decreases,” says Kelly O’Connor, RD, LDN, CDE, of Mercy Medical Center in Baltimore. “Research indicates the total body water content of a 75- to 80-year-old person is nearly 50% less than a young person. For some reason not yet clear, the decline in water content is even greater in elderly women.” Certain medications, like diuretics, antihistamines, blood pressure drugs, antipsychotics and corticosteroids, as well as medical conditions can also affect the elderly’s ability to retain fluids.
According to BBC News, research indicates that one in five seniors is not getting enough water/fluids on a daily basis. This same research also notes that persons who are living with dementia are even more at risk. They have a six-fold increased risk of dehydration. They may forget to eat and drink, not know when they are thirsty, may not be able to get beverages by themselves, or may have swallowing difficulties in the advanced stages. Dehydration is also a factor in the occurrence of urinary tract infection (UTIs).
What are the signs of dehydration?
Signs of mild or moderate dehydration include:
- Dry or sticky mouth
- Not peeing very much
- Dark yellow urine
- Dry, cool skin, headache,
- Muscle cramps
Signs of severe dehydration that may require emergency treatment include:
- Extreme thirst
- Not urinating
- Very dark or orange-colored urine
- Very dry skin
- Rapid heart rate
- Confusion or irritability
- Rapid breathing
- Fainting or unconsciousness
Two quick tests to check for dehydration
The website, EverydayHealth.com, indicates that there are two simple ways to check for possible dehydration.
- Skin test. Use two fingers to grab a roll of skin on the back of your hand between where your watch sits and where your fingers start. Pull the skin up to about a half to one centimeter high. Then let the skin go. It should spring back to its normal position in less than a couple of seconds. If the skin bounces back slowly, it may be that you are dehydrated. (This test is not foolproof, however.)
- Checking urine color. If you are well-hydrated, your urine will be mostly clear with a tinge of yellow color. When your body is about 3% dehydrated, the color will be noticeably yellow. When your body is more than 5% dehydrated, urine will appear orange.
Prevention is key
The best way to prevent dehydration is to consume an adequate amount of fluids during the day. Studies have shown that elderly adults who drink five 8-ounce glasses of water per day experience lower rates of fatal coronary heart disease. If your loved one is taking medication that requires it to be taken with water, it is critical to do so.
Drinking water at room temperature is recommended for quicker absorption, but in the summer, your loved one may prefer a cool drink. Water flavored with citrus or other fruits, as well as sparkling water are options to try. Coffee and tea act as diuretics, so avoid drinking a lot of these. Avoid alcohol and caffeinated drinks if the person is dehydrated. If your loved one has difficulty swallowing, try pulpy orange juice or prune juice.
About 20% of our fluid intake comes the food we eat. Eating the following foods which have a high water content will help with fluid retention. Strive to include one or two of these at each meal:
- Vegetables: tomatoes, cucumbers, zucchini, lettuce, celery, cooked asparagus, raw or cooked broccoli, spinach, carrots, red bell peppers
- Fresh Fruits: watermelon, pineapple, cantaloupe, grapes, strawberries, honeydew melon, papaya, apples
- Soups: chicken or beef consommé or broths
Tips to help keep your loved one hydrated
- Create a schedule for daily intake of fluids.
- If your loved one has limited coordination or dexterity, and struggles to drink from a cup, serve drinks in a two-handled cup with a sturdy base.
- Provide a variety of choices of fluids in easy-to-drink glasses; e.g. fresh lemonade, Gatorade, water with citrus, herbal teas without caffeine.
- Make a spritzer by pouring a half cup of club soda or seltzer water to a half cup of desired fruit juice. Stir in plenty of ice.
- Leave “kid-size” water bottles near where they sit and at the bedside.
- Offer small amounts of water with medication unless more is required to be taken with the particular medication.
- Prepare Knox unflavored gelatin with orange juice for a “natural” jello.
- Prepare popsicles with fruit juice for a summer treat.
- Keep a small bottle of water in the car for sips while traveling to and from doctor visits and while on errands.
Lastly, make sure that you also take care of yourself and get plenty to drink throughout the day. Your loved one depends on you to stay healthy and hydrated.
I wish you peace, patience, and joy in your caregiving today and every day!
* * *
The National Institute on Aging has a helpful tip sheet on hydration, “Drinking Enough Fluids.” Check it out here: https://go4life.nia.nih.gov/tip-sheets/drinking-enough-fluids.
* * *
For several more ideas to prevent dehydration, these come from the Alzheimer’s Association of Western and Central Washington State Chapter: http://www.alz.org/alzwa/documents/Techniques_for_Prevention_of_Dehydration.pdf.
* * *
The website, “Eating Well.com,” has a slideshow, “How Much Water to Drink? Eight Water Facts and Questions Answered:” http://www.eatingwell.com/nutrition_health/nutrition_news_information/how_much_water_to_drink.