Dehydration in the Elderly – Prevention, Risks, And Symptoms

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We all know that we should drink plenty of water and stay hydrated, in order to remain fit and healthy. From time to time, it’s normal to forget to grab a glass of water and as a result you’re left feeling thirsty. 

Dehydration is dangerous, no matter what your age, but elderly people have a much higher risk of developing this condition than those who are younger. The reason is due to the overall process of aging, and the changes which occur within the body. In some cases it can also be that an elderly person becomes forgetful, and they may forget to drink as much water as they know they should. 

Several conditions which are common to the elderly, also linked with an increase in frailty generally, can add weight to the dangers of dehydration, as well as the potential outcomes as a result. 

For that reason it’s vital that you know about the dangers of dehydration, the potential outcomes, understand the signs and symptoms, and know what you can do to prevent dehydration in the first place. 

What Causes Dehydration in The Elderly?

Simply forgetting to drink can be a cause of dehydration, especially those who may be suffering from dementia. In addition, conditions such as dementia or having had a stroke can change the way a person recognises thirst. This means a person might be thirsty, but they don’t recognise the feeling and therefore don’t have a drink. As a result, they may become dehydrated. 

There are several physical health problems which can increase the risk of dehydration, including problems with kidney function. In this case, dehydration is likely to be more severe and cause consequences which you are better to avoid. On top of this, many medications can cause a higher chance of dehydration, and the fact that many elderly people on a cocktail of different medications for various problems means that the chances of this risk factor coming into play are far higher. 

Of course, as a person ages they also may develop problems with bladder and bowels. This can cause them to become worried about becoming constipated or suffering from dehydration or incontinence. This could cause them to inadvertently restrict their fluid intake, trying to avoid accidents whilst out and about. By doing this, they’re putting themselves at a higher risk of dehydration, without even realising it. 

As you can see, there are many different possibilities and reasons why an elderly person may become dehydrated, and raising awareness of the problems this can cause is vital. Care givers need to be aware of how much their elderly person is drinking and ensure that they get enough fluids in a day, monitoring any issues that may occur. Elderly people who look after themselves also need to be aware of the risks of dehydrated and the reasons why it may occur. 

By doing this, the chances of a real problem occurring are drastically reduced. 

What Happens if an Elderly Person Becomes Dehydrated?

The consequences of an elderly person become dehydrated vary from person to person and it really depends upon their general state of health in the first place, as to the severity of the issue. It’s worth remembering however that even the fittest person in the world will suffer severe problems if they allow themselves to become dehydrated, so you can imagine the consequences for someone who isn’t in the best of health to begin with. 

An elderly person has a higher chance of being admitted to hospital with dehydration than someone who is younger, and they have a far higher risk of this leading to severe complications, perhaps even resulting in death in the worst case scenarios. 

Mild dehydration still has its complications and can cause a person to feel generally lethargic, slow, unable to concentrate, and problems remembering things. This worsens as the dehydration continues. 

Dehydration can also include low blood pressure, which in itself can be dangerous, an increased risk of memory lapses and falls, general lethargy and weakness, and dizziness. All of this can be extremely dangerous to an elderly person, especially if they are living alone. It’s not unusual for the main reason for a very severe fall, resulting in injuries, to be because the person was dehydrated and become confused and dizzy as a result. 

Another potential consequence is an increased chance of developing a water infection, or urinary tract infection (UTI) or having problems with their bowels, usually constipation. Again, these worsen as the dehydration worsens too. 

What Are The Signs of Dehydration?

The reason why dehydration is such a risk in the elderly is because much of it relies upon them telling you how they feel, if they’re not able to recognise for themselves that they are actually thirsty. The main symptoms of dehydration are:

  • Dry mouth
  • Dry lips, including chapped lips 
  • Dry tongue
  • Dry skin
  • Sunken eyes
  • Confusion
  • Tiredness
  • Feeling disorientated
  • Dizziness
  • Muscle cramps
  • Headaches
  • Problems sleeping
  • Very dark urine which often has an odour to it

If an elderly person has developed severe dehydration then they will typically show many of the symptoms above but also have worsening muscle cramps, a stomach which appears distended or bloated, fast breathing or a weak pulse. In this case, urgent medical attention needs to be sought immediately. 

How to Prevent Dehydration in The Elderly 

The best way to try and prevent dehydration is to know how much fluid your elderly relative or person has had and to ensure that they’re getting enough. If you feel that they’ve not drunk enough fluids, you need to encourage them to drink a little more and keep their levels up. 

As we mentioned earlier, some conditions can cause a person to misinterpret the sensation of thirst, meaning they’re not likely to give much thought to it or remember that they haven’t had a drink in a while. In that case you need to be aware of this and ensure that they keep drinking throughout the day. 

In care homes, dehydration is a known problem. This can be because of a range of reasons, such as an elderly person worrying that if they drink more water they’ll need to go to the toilet more often and as a result they might not make it in time if they’re a little less mobile than they used to be. If an elderly person is unable to get up without assistance, they may not want to bother someone when they want a drink. 

There are many reasons why this might be the case in a care home setting, but staff need to be trained in dehydration issues and know to be on the lookout and be aware when their residents haven’t had enough to drink, ensuring that fresh water is on hand for everyone, at all times. Being available is also a must do, as some elderly people may not be able to get up and reach a drink for themselves. This can be difficult in terms of staffing, but it’s something which needs to happen in order to prevent dehydration issues from occurring in the first place. 

So, how much water should an elderly person drink a day? There is a lot of debate about the right amount of fluids, but the general consensus is that they should have at least 6 to 8 glasses of water (8oz glass at a time) per day, but this can also include other fluids such as water flavoured with juice. 

A drink should always be accessible and if in a care home, elderly people should feel able to ask whenever they want a drink too. Of course, if your elderly person is at home, they should be able to get up and fetch a drink when they want one, or ask their carer, who should also be very aware of their fluid intake throughout the day. 

If your elderly relative or loved one finds it difficult to drink from a cup or glass, be sure to offer a special type of cup, perhaps one which has a straw attached to it, or simply use a straw instead. This may help to encourage them to drink more fluids. Remember, elderly people are often very aware of not wanting to ask for things all the time; take this worry away by simply being one step ahead and having a drink on hand whenever they want one. 

How to Encourage an Elderly Person to Drink More Fluids

Aside from trying a special cup if they find it difficult to drink straight from a glass, what else can you do if you’re having trouble encouraging them to keep their fluid uptake a little higher? This can be a particular problem if they simply don’t feel thirsty or they are worried about having an accident and not getting to the toilet on time. 

  • Try mixing up water with a little fruit juice or opting for flavoured water
  • Try and encourage them to drink by avoiding telling them they must drink, and instead showing it as an enjoyable beverage
  • Choose a drink which they can sip at over time, e.g. they can place it down on the table beside them and keep drinking 
  • Try and get them to drink more in the daytime; many elderly people worry about having to get up to go to the toilet too much during the night and will therefore restrict their fluid intake as a result. By drinking more in the day, they can compensate and avoid the problem
  • Make sure they’re drinking enough water when the weather is particularly warm, as this can be a very easy cause of dehydration in the elderly

Whilst you should never force fluids onto an elderly person against their will, you should certainly encourage them to keep drinking throughout the day. Mixing drinks up and making them more appealing is a good option, and you could also sit down and have a drink with them, which is more likely to encourage them to copy you and do the same. 

Elderly people who live alone should also be monitored carefully in terms of how much they’re drinking, to avoid dehydration. You should be on the lookout for any symptoms of dehydration, as we mentioned above, but you should also do your best to ensure they have easy access to fluids too. You could mix up a jug of fruit juice and leave in the fridge, or you could simply make sure that they have a few different juice options at home, to grab when they need them. 

It’s a good idea to try and avoid high sugar content drinks, such as full fat cola, etc, and instead to opt for water and sugar free juice, or water with slices of fresh fruit inside. This is far more healthy. You could also try and avoid too much caffeine, for the exact same reason.

Simply making fluids accessible is a good way forward, whilst knowing and understanding the particular symptoms of dehydration. Try encouraging your loved one to keep drinking by helping them to understand the potential consequences of not drinking enough too. They may simply think that they’re not going to go to the toilet quite so often, and maybe even see that as a good thing, but the reality is quite different. 

It can be hard if they don’t recognise the feeling of thirst. If an elderly person feels thirsty, they’re more likely to actually get a drink or ask for one, but the chances are a slim if they have a condition which causes them to not really recognise the sensation of thirst in the same way. These are the situations which require you to step in and be the eyes of the situation, ensuring that plentiful fluids are taken every single day.

Dehydration is a very serious issue when left unattended and in the elderly this can be even more severe, and even deadly. Focusing on good quality fluid intake can overcome the challenges and problems at hand.