Dehydration is a common condition that afflicts many people over the age of 65. Because the symptoms of dehydration are masked by the aging body, patients and caregivers typically overlook the warnings signs until it is too late. But, dehydration can be avoided if you are careful and know what the symptoms are.

What is dehydration?

Dehydration is a condition when the body is losing more water than it is taking in. Loss of water can be due to medications, illnesses, inability to move around easily, diminished sense of thirst, or reduced kidney function. At times, seniors are dependent on caregivers who may not realize they are not taking in enough fluids.

A factor in elderly dehydration is the increased risk of contracting illnesses such as the common cold and influenza. These illnesses cause fluid loss that is not easily replenished. If possible, it is a good idea to take extra precautions during cold and flu season so your loved one does not get sick.

Another reason elderly persons become dehydrated is because of their medication. With the various health conditions that develop in the senior years, it is not uncommon for people over the age of 60 to be taking multiple medications. Medications to monitor and control heart disease, hypertension, kidney disease, and liver disease are common diuretic medications prescribed for seniors. While the patients realize that these medications are diuretics, they often overlook their need to add more fluids to their daily diet as they take their prescribed medications, and this causes many of them to become dehydrated.

Sometimes people in advanced years who live on their own do not drink enough water or other fluids to maintain their health. This can be for a variety of reasons, but a common reason is that deteriorating muscles make it more difficult for them to get up and move around, which discourages them from simply going into the kitchen for a glass of water. Some of them also find it difficult to regularly get up to go to the bathroom, so they purposely reduce the amounts of fluids they consume so they do not have to urinate as frequently. Friends and family who regularly visit with their loved one may not realize that the person is dehydrated until they are in an emergent situation.

What are the symptoms of dehydration?

Usually, the first symptom of dehydration to present is a dark or malodorous urine. This is closely followed by decrease in urine output and chronic constipation. Urinary tract infections could develop over time. When the body is not properly flushing itself of toxins, these toxins can cause infections. So, if the person is not getting enough fluids, they are not voiding the toxins regularly.

Some of the first symptoms of severe dehydration include chronic fatigue and lethargy. Many times the person will nap for a couple hours once or twice a day. As the dehydration develops, the muscles will become weak and sometimes the person will develop muscle cramps. Too often people excuse these symptoms as signs of aging, but more often than not it can be corrected by re-hydrating the person.

Dehydration can also cause confusion and weakness. If your elderly charge is otherwise sound in mind and body, but suddenly displays confusion and/or weakness, they may be experiencing dehydration. Typically, an increase in their fluid intake will relieve these symptoms. However, these two symptoms can be indications of a number of different conditions. So, if the symptoms persist after increasing their fluids, you may want to consult a doctor to determine if there is another condition presenting itself.

Headaches are also a common symptom of dehydration in younger people, as well as wrinkled or sagging skin. However, these symptoms may not be evident in elderly patients. Headaches alone do not necessarily indicate dehydration, but combined with any other symptom could identify possible dehydration. Checking the skin for proper elasticity also can help identify early stages of dehydration. Pull up the skin on the back of the hand, and if the skin does not return to its normal state within a second or two, the person is likely suffering from dehydration.

More symptoms to look for include: dizziness, dry mouth, sudden problems with mobility, low blood pressure or severe change in blood pressure when standing up, rapid resting heart rate, irregularity in body temperature (too cold or feeling hot without producing sweat), inability to produce tears, or “sunken” eyes. Patients who are bed-ridden experience bedsores more readily when dehydrated than those who are able to get up and move around frequently.

How can dehydration be prevented?

Humans can only survive approximately four days without fluids. The goal is to not allow that to happen. Unfortunately, each person’s hydration level is different. Where one person may need 6-8 glasses of water every day to stay hydrated, someone else may only need 4-6 glasses of water. Simply monitoring body weight daily can indicate if a person is entering a dehydrated state. If the person loses two or more pounds from the previous day and feels thirsty or has a severe headache, they are probably dehydrated. Prolonged dehydration can cause other health issues, such as cardiac or renal problems. Patients who already have cardiac or renal conditions will have more severe reactions to even slight dehydration.

If your loved one has trouble walking or getting to the kitchen, consider keeping a water bottle or two next to their chair or bed. If they are not able to lift a full one liter bottle, then leave three 12 ounce bottles beside them. Also, water is not the only liquid they can consume to stay properly hydrated. Coffee, tea and lemonade are water based and will provide your loved one with a variety of fluids to consume, which will keep them from becoming bored with their fluid intake. In moderation, the caffeine in coffee and tea and the sugar in the lemonade should not adverse affect their metabolism or blood-sugar levels.

Some of the things we eat, such as fruits, vegetables and soups, contain water and are good sources of hydration. If a glass of fluid is added to the daily meals, we can ensure that our loved ones are getting fluids regularly. According to information found on the MEDLINEplus website, some fruits and vegetables which are comprised of 90% or more water are: cooked asparagus, raw bell peppers, cooked or raw broccoli, raw cabbage, cantaloupe, cooked or raw cauliflower, raw celery, raw cucumbers, grapefruit, honeydew, raw lettuce, raw strawberries, raw tomatoes, and watermelon. Adding one or two of these items to every meal provides more fluid in the diet and satisfied the daily recommended serving of fruits and vegetables, which also provides vitamins and minerals the body needs.

One of the most important ways to avoid dehydration is to be educated about the medications your loved one is taking. There are many medications that are diuretics, which means that more fluids will need to be consumed daily to avoid dehydration.

Dispelling the Myths:

MYTH: If they are dehydrated, they will be thirsty.

TRUTH: As people age, they lose some of their basic senses. They can lose their sense of smell, sense of taste, and ability to identify when they are hungry or thirsty. Along with making sure your loved one eats properly, you also need to make sure your loved one is drinking enough fluids.

MYTH: Every elderly person needs to be weighed every day to insure they are not losing too much weight and possibly dehydrating.

TRUTH: While it is a simple method to identify possible dehydration, it is not necessary to weigh the patient daily in every instance. An active elderly person who is mobile and does not require constant care would not need to weigh themselves every day to make sure they are not dehydrating. However, a patient in a nursing home – especially if they have already experienced dehydration – should be weighed at a minimum every two days to make sure they are not in danger of dehydration.

MYTH: Using a scale that also measures body mass and hydration levels can help prevent dehydration.

TRUTH: Don’t believe the marketing on every product. Unfortunately, these scales have not proven to be accurate. Until the manufacturers can perfect the technology for these products, watch for other signs that your loved one is dehydrating.

MYTH: The caffeine in coffee and tea will cause further dehydration.

TRUTH: 1-2 cups of a caffeinated beverage will not be enough to cause dehydration in a person. However, large amounts of caffeine could trigger the diuretic properties of the substance. As with their food consumption and vigorous exercise, everything should be done in moderation.

Because it is difficult to diagnose dehydration in elder persons in its early stages, severe dehydration frequently results in hospitalization. If left unchecked long enough, it can be life-threatening and can even result in death. It is important for caregivers and even elderly patients to be watchful of the symptoms and seek medical assistance if the symptoms persist beyond one or two days.

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