How to Prevent Dehydration in the Elderly

In the winter months we are familiar with hearing how the cold weather affects our elderly. We are therefore more on the lookout for potential problems. However, we don’t always realise that the warmer months bring unique challenges too. The elderly are often particularly vulnerable to dehydration. At this time of year we need to be more aware of this.

Dehydration in simple terms is when the body’s need for, and use of, water exceeds the intake. The ‘net loss’ of fluid results in the body having too little water to work properly.

Changes in the body due to ageing, different diseases, medical side effects, and cognitive and physical limitations can all contribute to an elderly individual being at risk of dehydration.

Dehydration in elderly dementia patients, for example, is a certain concern which we need to look out for.

Furthermore, predominantly with dehydration in elderly dementia patients, we see diseases such as Alzheimer’s affecting their ability to swallow properly, or a reduced ability to feel thirsty. They may also have concerns about incontinence. Together these can exacerbate the problem.

The Problem with Dehydration in Elderly People

Dehydration is not an innocuous problem. It is associated with poor health outcomes; it increased chance of hospitalisation, further illnesses and health complications, and even fatality.

If caught early, it can quickly be overcome by upping fluids; but if left unchecked, it causes greater complications.

Even at a lesser level, dehydration can impact on mental performance and wellbeing. In some cases, dehydration can even mimic symptoms of dementia itself.

Dehydration can lower blood pressure and therefore increase weakness and dizziness, and with this the risk of falls increases.

Symptoms of Dehydration in Elderly Patients

We all need to be aware that dehydration is a real risk for many elderly individuals and the consequences of dehydration are more dangerous than for much of the population. Therefore, it is important to be able to spot the common symptoms of dehydration in elderly people.

Unfortunately, it is not always a straightforward thing to spot. Sometimes the symptoms of dehydration can be mistaken for something else, missed, or dismissed as a normal part of ageing or worsening dementia.

Familiarity with the warning signs can help. The most obvious symptoms include:

• Increase in mobility issues, stability, and ability to walk.
• Dizziness, light-headedness, disorientation, and worsening confusion.
• Frequent headaches.
• A dry mouth, tongue and lips or sticky gums.
• Low blood pressure with tachycardia (fast heart rate).
• Strong coloured and strong smelling urine or decreased urination.
• Sunken eyes with minimal tear formation.
• Reduced skin elasticity, or dry skin.
• Changes in mood.

It is also not unusual for elderly individuals who are dehydrated to develop pressure sores as well as worsening skin conditions or new skin problems. Urinary tract infections can also be more frequent.

Preventing Dehydration in the Elderly

It is therefore vital that steps are taken to prevent dehydration in elderly loved ones and residents in care homes.

The most basic step is to recognise when an individual isn’t drinking enough and encourage them to drink. Of course, this is simplistic and sometimes tricky to do. We suggest some other methods if this first line of prevention fails:

• Identify the hurdles: Different people have different barriers to drinking enough. For some patients it may be mobility concerns about reaching the toilet in time making them cut back on their fluid intake. For others they may be depressed and unmotivated. Others may forget to drink without reminders. If you can identify what the barriers are to drinking adequately then this can help the elderly individual to be more willing to drink more.
• Increasing social drinking: For many elderly people their social interaction decreases, and with it, the social aspect of enjoying a drink with another person. Therefore, a relatively simple step can sometimes be to add in opportunities for social drinking such as having visitors.
• Providing choice: Elderly people who are unable to do their own shopping may find that they don’t have the choice of drinks they would like. Do they have a mixture of options including hot and cold drinks? By increasing the availability of drinks you can entice them to drink more. Furthermore, having these available within reach is important.
• Keep water fresh: By ensuring that available water is fresh and frequently changed and refilled you can encourage more drinking. Additionally, drinks should be routinely offered to elderly people throughout the day. It can also help to offer a full glass of water when someone is taking their medication
• Offer assistance: Consider whether the elderly person would benefit from help, including specialised drinking aids and cups.
• Dietary methods: If an elderly person is reluctant to drink fluids you can incorporate more ‘wet’ food in their diet such as yoghurts, custard, soup, vegetables and jelly.
• Reduce caffeine and alcohol: Both of these are diuretics so can make dehydration worse.
• Essential vitamins: Make sure to have nutrient dense foods available, which provide essential vitamins.

If you are concerned that your elderly relative is significantly dehydrated, or you are having problems ensuring they drink enough, you should speak to their GP, care home staff, or healthcare provider.