Dehydration in Seniors: Risks, Warning Signs, and Tips

Dehydration in your loved one can be easily avoided. Awareness is the first step in preventing any health issues related to dehydration-- the most common being the lack of fluids.

Unfortunately, most people aren't aware of just how problematic dehydration can be for senior adults and just how common it is.

These facts can help you understand how serious this affliction can be: 

• According to a review article in e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, a study found that around 31% of long-term patients were dehydrated. 
• It costs roughly $1.36 billion annually to treat the elderly community that has been hospitalized for dehydration. This information comes from the Nutrition and Healthy Aging article. 
• Patients suffering from dehydration are six times more likely to pass in the hospital than those who are not dehydrated, as the Age and Aging study said. 

What Is Dehydration?

Dehydration happens when your body doesn't ingest enough water. Water is the source of life, and as exaggerated as that may sound… it is not.

Water is necessary for many of your body's day to day functions, such as:

• Temperature regulation
• Waste elimination
• Joint lubrication
• Delivery of nutrients to cells
• Blood oxygen circulation
• Skin hydration
• Cognitive function

Dehydration occurs when your body doesn't get enough water to sustain these day-to-day processes. 

Thankfully, your body is designed to adjust its fluid levels throughout the day. The most common way is through thirst. As your body drops in fluid levels, your hypothalamus alerts your brain and creates the sensation of being thirsty. The following most common reaction is when your kidneys preserve water, which leads to urine becoming more concentrated.

It can be challenging to maintain the correct amount of liquid to avoid dehydration. This is primarily hard because your body loses water through sweat, urination, and other normal bodily functions. 

Why Dehydration Is More Common Among Seniors

It can be a complex process to keep up with the amount of water and electrolytes for seniors compared to younger people. Senior adults are more likely to become dehydrated, and the complications that are side effects of this are severe. 

Frontiers in Molecular Biosciences shared that dehydration is one of the top 10 reasons seniors become hospitalized. Dehydrated adults hospitalized can then end up in more intensive care units, more likely to be readmitted, and more likely to be placed in long-term care facilities. 

What is the link between age and dehydration? Elderly adults are more likely to become dehydrated due to the several health or lifestyle conditions that they are experiencing that lead to low fluid levels.

The most common factors are: 

• Age-related physical changes

With age, our bodies cannot hold as much water-- this is most commonly because our kidneys become less efficient. Other risks come from seniors drinking less than younger adults because older adults have a weakened sense of thirst. There is no clear scientific reason for this, but it is genuinely a troublesome symptom of age. The reduced sense of thirst is most common for those that live with Alzheimer's disease or other forms of dementia, as well as those who have suffered from a stroke. These elderly adults may have a hard time swallowing or asking caregivers for help.

• Medication side effects

There are many common medicines that older adults take that can act as diuretics (i.e., they can increase urine production) and lead to dehydration. All side effects of medicine should be discussed with a doctor before taking it. 

• Incontinence issues

The risk of dehydration when associated with incontinence is directly caused by the fluid lost during involuntary urination. Dehydration happens when seniors begin to limit their fluid intake to avoid any uncomfortable situations. It is important to let our loved ones know that reducing their fluid intake is not directly correlated to incontinence. The National Association for Continence shared that drinking more water can help fight off incontinence for some seniors. Staying hydrated also keeps your bladder from being vulnerable to bacterial infections-- reducing the risk of UTIs.

• Fear of falling

It is common for seniors to drink fewer fluids due to the fear of falling if they need to use the restroom in the middle of the night--these seniors are not considering that they are putting themselves at risk for dehydration when doing this. A way to avoid late-night restroom trips while also drinking fluids is to restrict fluid intake a few hours before bedtime.

• Living conditions

Elder adults living at home can use Visiting Angels caregivers to assist with daily needs, including water intake. 

• Medical issues

Most seniors suffer from medical conditions that have been shown to lead to dehydration. The most common examples of this are diarrhea, fever, and diabetes.

Signs of Dehydration in Elderly People

It is crucial to be aware of the signs and symptoms of dehydration to act quickly. The effects of dehydration can set in fast with seniors, so it is essential to be aware and know how to react. 

Symptoms of dehydration are also progressive for older adults. The early signs to check for in an older adult are: 

• Cracked lips
• Dry skin, particularly in the armpits
• Dry mouth
• Less frequent urination than normal

More severe effects of dehydration in the elderly are:

• Dark-colored urine
• Crying without tears
• Strong-smelling urine
• Muscle cramps
• Dizziness
• Increased heart rate
• Headaches
• Confusion
• Fainting
• Irritability
• Fatigue

It is essential to keep this one fact in mind: thoughts in their senior years don't always show clear signs of dehydration. Examples of this are:

• Dehydration can cause hallucinations
• Some medicines can affect the color of urine
• Cognitive changes can happen due to dementia or medications. 

So how do you correctly spot and label dehydration? The best option is to drink water. After 10-15 minutes, you should see improvements. If things are really bad and water is not helping, go to the ER. If your senior is experiencing confusion, sleepiness, or unexplained irritability, you need to get to the ER as soon as possible. Never forget that getting prompt medical care is always the most reliable and trusted way to ensure your loved one is dehydrated. Medical professionals can test for dehydration through blood tests to check electrolyte levels and kidney functions. (Urine tests aren't always reliable for seniors.)

Treating Dehydration: What to Do and When

If you see an elderly adult dehydrated, the first step should be getting them to drink a glass of water. If they are not better after 10-15 minutes, you should call 911 or drive to the ER. 

At the ER, these patients usually start with an assessment to see the level of their condition. Mild cases require close monitoring and pushing of electrolyte-containing fluids. Moderate cases call for intravenous (IV) treatment. The more severe cases require more detailed and closer monitored interventions. 

Treatment and time needed for recovery for seniors can all depend on the degree of the condition and the individual's overall health. Responding quickly can assist in the recovery time-- this is why it is crucial not to neglect the symptoms shown. 

How to Prevent Dehydration in Elderly Adults

It is possible to avoid dehydration within the elderly community by following a few proactive strategies.  Simply put, seniors can stay hydrated by simply drinking water. Sadly, most seniors struggle to know how much water is enough. Most adults have heard that 8 cups of water a day is suggested. However, most doctors have backed away from this suggestion. Many factors influence the amount of water you should drink each day-- such as any medications you take, your body weight, and your activity level. The best way to gauge the amount of water your senior should be having is to ask their doctor. 

Your loved one can also drink other beverages to help fight off dehydration. The American Journal of Clinical Nutrition found that other beverages have shown to be more effective because they don't lead to much urine production. The study showed the best alternatives are: milk, orange juice, and commercially prepared electrolyte replacement drinks. When it comes to electrolyte drinks, remember to be mindful of sugar content. An easily accessible and suitable option is Pedialyte. 

Due to seniors' reduced sense of thirst, it can be difficult to ingest enough liquid each day. We have curated a list of tips that can make your beverages more appealing: 

1. Keep in mind that not all fluids come in a glass: Many fruits, vegetables, and soups can all be beneficial to your daily fluid intake. You can even get creative with your foods, like making popsicles with fruit juice or blending smoothies with fresh greens.
2. Use technology: Apps such as Hydro Coach or WaterMinder can track the number of drinks that you consume a day and alert you to remember to drink.
3. Keep drinks nearby and visible: It can be challenging for seniors to remember to drink fluid due to age or lack of access to fluids. Using an attractive water bottle can be an enticing way to encourage drinking and a positive way to have a drink at hand. 
4. Make drinks enticing and consider alternatives to water: Elderly adults complain about water being too bland; adding juice or drink mix can boost the appeal. Sparkling water is also a great option. (Remember that people with diabetes should limit sweet drinks, and seniors with hypertension should limit drinks with sodium.)
5. Create routines: Adding time to ingest fluid at specific times in your schedule is a good way to make drinking fluid a consistent habit. 
6. Work on fall prevention strategies: Working on your confidence in being on your feet can reduce the fear of falling at night when you need to use the restroom at night. 
7. Work with staff in assisted living facilities or nursing homes: When living in residential or long-term care facilities, seniors can face extra challenges when getting enough fluids.

Some strategies used in these facilities can include:

• Using beverage carts to offer drinks
• Serving plenty of soft foods with high water content
• Scheduling times for staff to remind residents to drink something
• Hosting "happy hours" with fancy, nonalcoholic drinks

Products that can help prevent dehydration:

Electrolyte powder: This can be used to restore and replenish electrolytes. 

Water bottle with time markers: using a 32-ounce, leak-proof bottle can assist with tracking water intake. 

Water flavoring drops: adding sugar-free drops to plain water can spice up your water game. Pro-tip: add to sparkling water as a healthier alternative to soft drinks.

SodaStream sparkling water maker: Using this machine can help reduce waste and save money. 

Kitchen timer: a kitchen timer can be used and set to offer reminders to take time during the day to drink fluids. 

Aquaphor lip repair ointment: dry or chapped lips can be a direct result of dehydration. When this happens, there are lip repair creams available.

Cetaphil moisturizing lotion: You can cure this with shea butter when your skin is dry and cracking. This product is non-greasy and made to protect sensitive skin for up to 24 hours.

Risks of Dehydration in Seniors

There are many common side effects of mild dehydration that people experience, regardless of age. Some of these common side effects are: 

• Fatigue
• Memory problems
• Poor concentration
• Irritability
• Headache

There are long-term effects of dehydration; seniors can experience one or multiple of the following symptoms when they are chronically dehydrated: 

• Low blood pressure
• Dizziness
• Skin problems, including pressure sores
• Constipation
• Kidney problems, including kidney stones
• Increased risk of urinary tract infections

If dehydration is left untreated, it can cause death. Here are the most serves dangers of dehydration: 

• Seizures
• Shock
• Kidney failure
• Heat exhaustion or heat stroke

A person can typically survive about three days without water (this also depends on the individual's overall health). But it is a general rule of thumb that a loss of more than 10 percent of a person's body weight through fluid loss is a medical emergency-- this can lead to death.

Knowledge Is Prevention

The first step of avoiding dehydration is to be aware of the risks. Be open with healthcare providers about creating strategies for consuming enough liquids. Be aware of signs and/or symptoms in yourself and your loved ones. This is a serious condition but completely avoidable.

Reach out to Visiting Angels Hoboken for further details about dehydration in seniors.