Preventing, Detecting, and Treating Dehydration in Aging Adults

It's important for caregivers to recognize the signs of dehydration in the elderly, treat it promptly, and know how to prevent it from occurring.

Sudden shifts in the body's water balance can result in dehydration, and the physical changes associated with aging expose the elderly in particular to its risks. A danger is that they may not know they’re dehydrated, which could lead to it not being treated and result in more serious consequences.

In one study of residents in a long-term care facility, author Janet Mentes reported that 31 percent of patients were dehydrated. In a related study, researchers found that 48 percent of older adults admitted into hospitals after treatment at emergency departments had signs of dehydration in their laboratory results.

What causes dehydration in the elderly?

Dehydration in seniors is often due to inadequate water intake but can happen for many other reasons including diarrhea, excessive sweating, loss of blood, diseases such as diabetes, as well as a side effect of prescribed medication like diuretics. Aging itself makes people less aware of thirst and gradually lowers the body's ability to regulate its fluid balance.

Older people may not feel thirst as keenly.
Scientists warn that the ability to be aware of thirst is slowly blunted as we age. As a result, the elderly do not feel thirst as readily as younger people do. This increases the chances they will consume less water and consequently become dehydrated.

Less body fluids, lower kidney function.
The body loses water as we age. Until about age 40, the proportion of total body fluids to body weight is about 60% in men and 52% in women. Men tend to have greater muscle mass and lower body fat, and muscle cells contain more water than fat cells. After age 60, the proportion goes down to 52% in men and 46% in women. Muscle mass decreases and body fat increases.

In addition, the kidneys' ability to remove toxins from the blood progressively declines with age. This means the kidneys are not as efficient in concentrating urine in less water, thus older people lose more water.

If dehydration is not identified and treated, the consequences are significant, including reduced or loss of consciousness, rapid but weak pulse, and lowered blood pressure. The situation can become life-threatening if not addressed.

Recognizing Dehydration Symptoms

Caregivers should watch for these signs:

Mild Dehydration Symptoms

• Dry mouth or dry tongue with thick saliva
• Inability to urinate, or can only pass small amounts of urine that is dark or deep yellow
• Cramping in limbs
• Headaches
• Crying but with few or no tears
• Weakness, general feeling of being unwell
• Sleepiness or irritability

Serious Dehydration Symptoms

• Low blood pressure
• Convulsions
• Severe cramping and muscle contractions in limbs, back, and stomach
• Bloated stomach
• Rapid but weak pulse
• Dry and sunken eyes with few or no tears
• Wrinkled skin; no elasticity
• Breathing faster than normal

The Benefits of Staying Hydrated

Everyone knows – but many people seem to forget ¬– that water is what sustains life. Here are just two of the benefits of being hydrated:

1. Better Digestive Health. Older people who get enough water tend to suffer less constipation, use less laxatives, and, for men, it may reduce the risk of bladder cancer. Less constipation may also reduce the risk of colorectal cancer.
2. Improved Heart Health. Drinking at least five 8-ounce glasses of water daily reduces the risk of fatal coronary heart disease among older adults.

Proper hydration also decreases the risk of falling. Caregivers should make sure their loved one has water by their side at all times. Encourage frequent drinking, but in moderate amounts.

A good formula for how much water is needed every day is to take one-third of the person's body weight in pounds and drink the equivalent number of ounces of water daily. For example, a 150-pound woman would need 50 ounces of water daily, or about six 8-ounce glasses of water.

Other Hydration Tips:

• Increase the water intake gradually if they are not currently drinking enough water.
• Encourage your loved one not to wait until they are thirsty to start drinking water because, at that point, dehydration has already started.
• Check to see that their urine is clear or pale yellow and not dark.
• Avoid alcohol and minimize the number of beverages with caffeine due to its diuretic effect.
• Offer a sports drink if you see early signs of dehydration to help replenish the body’s water and electrolytes.
• Seek medical attention immediately if you suspect signs of severe dehydration.