Always On Call Health Services

Dehydration in the Elderly

Water is essential for life and overall health and bodily function.  Humans need a minimum of 6-8 cups of fluid (approximately 48 to 64 ounces) daily for maintenance. This amount needed each day is not a one size fits all. Each person is different and their need for fluids is different.  The amount is not as important as the fact that the person must take in what they use up in order to maintain proper bodily fluid balance.  If this balance is not maintained bodily functions and overall health are compromised.

Dehydration occurs when more bodily fluid is lost than is taken in. Sometimes this is as a result of inadequate fluid intake but may also occur as a result of medications, illness or disease, aging process and even as a result of lifestyle habits. Dehydration may occur at any age but it is of particular importance for the elderly and can be life threatening when severe.

The elderly are more at risk of dehydration because they have less bodily fluids, are not able to regulate fluid balance as easily and they are not as aware of being thirsty as a younger person.

Increased Risks Due to Dehydration:

  • Constipation
  • Urinary tract infections
  • Respiratory infections
  • Kidney stones
  • Cardiac issues
  • Blood clots

Untreated dehydration can also lead to a higher incidence of falls as well as lead to medication toxicity and longer stays in rehab facilities.

Factors that Directly Influence the Risk of Dehydration in the Elderly:

  • Being over 85 years old
  • Having a chronic disease (like Alzheimer’s, Diabetes, Parkinson’s, kidney Disease, etc.)
  • Side effect of medications, especially diuretics, blood pressure medications and antidepressants
  • Fear of being incontinent- Drinking less on purpose due to fear of an accident
  • Swallowing disorders (may be caused by a variety of conditions such as having a stroke)
  • Being bedbound
  • Fever (the higher the fever, the more replacement fluid you need)
  • Illness, Diarrhea and Vomiting
  • Blood loss due to surgery or injury
  • Decreased kidney function
  • Dementia
  • Obesity
  • Excessive sweating
  • Hot weather

In the elderly, dehydration may present with vague symptoms so it is important to monitor fluid intake before the dehydration becomes severe and life threatening. 

Early Warning Signs of Mild Dehydration:

  • Thirst
  • Dry tongue, mouth and/or nose
  • Thick saliva
  • Unable to urinate or dark colored urine (urine should be clear or pale yellow)
  • Dry skin
  • Fatigue, Sleepiness
  • Dizziness, headaches
  • Crankiness, irritability
  • Confusion and disorientation
  • Cramping in limbs
  • Weakness, general malaise

Warning Signs of Severe Dehydration:

  • Weak, rapid pulse
  • Wrinkled skin lacking normal elasticity
  • Rapid breathing
  • Low blood pressure
  • Dry, sunken eyes
  • Severe cramping of limbs
  • Bloated stomach
  • Convulsions
  • Shock

Severe dehydration will require immediate medical attention to prevent the situation from worsening.

Tips to Prevent Dehydration in the Elderly Population

  • Offer fluids in various forms like water, ice, popsicles, broth, soups, stews, gravies, sauces, juices, fruits and vegetables.
  • Encourage sips or small amounts of fluids frequently throughout the day, keeping fluids nearby and easily accessible at all times. If you wait till the person is thirsty, dehydration has already begun.
  • Avoid coffee, tea, alcohol and high protein drinks as they are diuretics, which cause the kidneys to excrete water increasing risk of dehydration.
  • Have the elderly drink milk, juice or water with every meal.
  • Offer sports drinks like Gatorade to replace water and electrolytes.
  • Offer fruits and vegetables that are high in water content such as peaches, strawberries, blueberries, raspberries, cantaloupe watermelon, oranges, plums, cucumbers, lettuce, tomatoes, cauliflower, broccoli, zucchini, radishes, celery, cabbage, peppers and spinach.
  • Offer dairy products like milk, flavored dairy drinks and ice cream.
  • Encourage nutritional supplements and shakes.
  • Encourage drinking fluids during the day and less at night before bed, so that the person is not concerned about having to get up through the night to urinate. Fear of incontinence hinders drinking.

Being well hydrated has its’ benefits, especially for the elderly population. Maintaining the body’s proper fluid balance helps promote the action of medicines so that they work properly, helps to regulate body temperature, transports nutrients, oxygen, fat  and glucose to muscles so they work properly, aids in digestion, promotes proper bowel and bladder function, maintains skin integrity, and aids in proper organ function. Using the tips above will help prevent dehydration in the elderly and promote homeostasis and wellness.

Drink up for overall good health!