What is dehydration?
Dehydration is one of the most common reasons for the hospitalization of the elderly. The major reason for dehydration is a change in body physiology.
While about three-quarters of the human body is made up of water, this significantly changes as one ages. Older adults have about 60% of their bodies as water which makes them easily dehydrated.
Not drinking enough water can be dangerous for seniors since it is a necessary fluid for body functions. Water is used for pumping blood to the muscles, regulating body temperature and lubricating the joints among others.
What makes dehydration even more serious is that it is very easy for the signs of dehydration to go unrecognized. Early dehydration typically presents with muscle cramps, dizziness, fatigue and dry mouth. These signs could also be confused with the symptoms of other medical conditions or normal aging.
With long term dehydration a very significant risk for seniors it is important that it is diagnosed early. Additionally, it’s essential to take steps to prevent it from happening or recurring.
Why the Elderly are More Prone to Dehydration?
Dehydration affects between a fifth and a third of the elderly, with up to 48% of the elderly admitted in the hospital having dehydration. So what are some reasons for this phenomenon among the elderly?
1. Physiological Changes. The elderly experience a physiological change as they age, which reduces their body mass. The body’s composition goes from three-quarters water down to about 60% which throws their hydration out of balance as compared to younger adults.
2. Reduced Thirst Sensation. As people age, they tend to have a reduced thirst sensation. This means that the elderly are less likely to know when they need to drink. By the time they are thirsty, they are often in the early stages of dehydration.
3. Reduced Renal Function. Renal function typically declines with age from inadequate functioning of the anti diuretic hormone. This results in the kidneys losing their ability to concentrate urine. With the reduced effectiveness of the kidneys, the elderly tend to urinate more such that they lose more body fluids.
Medical Causes of Dehydration
1. Constipation and High Blood Pressure. Many of the elderly are afflicted with conditions that require them to take specific medications such as laxatives and diuretics that often result in excessive fluid loss.
2. Vomiting and Diarrhea. The elderly are more prone to diarrhea and vomiting due to weakened digestive and immune systems. This can result in excessive fluid loss that leads to dehydration.
3. Stroke and Alzheimer’s. These have been associated with reduced sensation to thirst that results in dehydration from the reduced need to consume fluids.
4. Dementia and Cognitive Problems. The elderly are more prone to forgetfulness due to dementia conditions such as Alzheimer’s. This means they can forget to take their recommended intake of fluids.
How to Identify Dehydration?
As previously mentioned, it is not so easy to diagnose dehydration given that it has a lot of symptoms common to other age-related conditions. However, the most effective way of diagnosing the condition is through laboratory testing. Some of the most common symptoms of the condition include:
- Low urine sodium concentration
- Elevated plasma serum osmolality
- Electrolyte imbalances
- Elevated blood urea nitrogen and creatinine
Dehydration can also be tested by measuring the specific gravity of the elderly’s urine using a dipstick urine test. Another way to check for dehydration is to look out for symptoms and physical signs that include: Dry skin in the armpit, less frequent urination, sunken eyes, high heart rate, delirium, low systolic blood pressure, weakness, and dizziness.
Ways to Get the Elderly to Drink More Water
Due to physiological changes, the elderly tend to drink much less water than they should. However, there are several techniques that can be employed to ensure that they take enough water to prevent chronic dehydration.
Getting the elderly to drink can help prevent major health problems. This means issues such as lower blood pressure, weak and rapid pulse, passing out, blood clot complications, and kidney stones. The following are some hydration tips seniors:
1. Have them Drink from as many sources as possible. You do not have to offer the elderly just water to get them hydrated. Spice it up by offering vegetables, fruits, sweetened beverages, fruit juice, coffee, and tea. If the senior does not like taking fluids, increase the water content in their food to get them properly hydrated.
2. Make water easily accessible. Seniors will sometimes not drink enough water because it is not easily accessible because of their mobility issues. As such, you need to have water on easy access by having a pitcher of water where they spend much of their time.
3. Set up leave notes and reminders. If your elderly family member is getting forgetful, you should have electronic notices around the house to remind them to drink. There are gadgets that include electric memos and clocks that can play when the elderly person has gone for a period without a drink. These can be very effective in solving the problem of dehydration.
4. Serve their drinks at different temperatures. Some elderly persons prefer cold while others love hot drinks. You need to experiment with your iced teas, warm juices, and hot coffees until you find the perfect temperature for the senior.
5. Prepare savory foods. Elders may enjoy drinking hot soup broth, particularly if they have a predilection for savory foods. You can serve the broth in powder, or from a box or can as long as they get their dose of hydration.
6. Make popsicles. One of the best ways to get the elderly to up their fluid intake is by making homemade popsicles. These are a mix of water and fruit juice that make for an excellent treat in the summer. Most elderly people enjoy homemade popsicles and will get their much-needed water from this treat.
7. Give them sports drinks, milkshakes, and smoothies. Some elderly will resist common fluids but will drink sports drinks, milkshakes and smoothies. These have a better texture and flavour and may just get the stubborn elder to drink more.
8. Identify continence issues. Try to find out of the elderly is having continence issues that may make them reluctant to re hydrate. One of the best ways of dealing with this is having a timed toileting approach. This way you can help them get to the bathroom so that they are not so reluctant to drink.
Are there gadgets that can be used to tell when a senior is dehydrated?
There are several ways to help you drink more water including having a “to do list” that includes “Drink more water”. However, increasing your water intake is not as easy as it seems. It is even harder for the elderly, who may have issues with dementia and other conditions that may make them forgetful. They also tend to have reduced sensation of thirst.
However, there are some high tech gadgets that have been invented that can help your senior drink fluids and keep themselves hydrated. These include smart water bottles and drinking water reminder apps and clocks that always remind the elderly to take their daily dose of fluids.
By using smart gadgets, you can help the elderly get their recommended water intake. This can be done either by having apps that track their fluid intake or by having digital reminders that remind them to take water at given intervals.
Results of Dehydration
The results of dehydration will depend on the severity of the dehydration and how long the senior has been dehydrated. Over the short term, the physical symptoms listed above will be evident. Older persons will typically be more prone to dizziness and passing out. Persons that have Alzheimer’s and other kinds of dementia may also experience heightened symptoms of those conditions. For instance, they may realize a deterioration in thinking and more confusion.
Dehydration can also result in the kidneys being less effective and hence the elderly person may experience more urination. Chronic mild dehydration may result in worsening constipation and increase the risk of kidney stones.
Low water intake has also been linked to urinary tract infections and urinary system diseases. These could be embarrassing, painful and uncomfortable and may make the elderly avoid water even more as they do not want to visit the toilet as often.
Long Term Effects of Dehydration
If dehydration is not arrested in time and is left to become chronic, it can result in dangerous health outcomes. Such outcomes can result in increased frequency of hospitalization and even death. Even mild dehydration can adversely impact the elderly’s mental performance that includes reaction time, concentration, attention, and memory.
Common complications that come with dehydration over the long term are increased risk of falling, dizziness, weakness, and low blood pressure. A dehydrated person is also more prone to developing skin conditions and pressure sores.
One of the most critical effects of not having enough water in the body is an increased risk of damaging the kidneys and developing urinary tract infections. The elderly who are suffering from dehydration are at higher risk of developing urinary tract infections and kidney stones over the long term.