Dehydration in the Elderly: Know the Signs

It's June, almost summer, and a great time to remember how significant of a risk dehydration is for the dear elderly that we care for. A call from a caregiver reporting a very healthy 84 year old's trip to the hospital today reminds us how quickly things can change. Reviewing the basics will increase awareness and support the power of prevention.

According to Jeannete Y. Wick, RPh, who wrote the article" Prevention and Management of Dehydration," the elderly are at greatest risk for dehydration, and those 85-99 years old are six times more likey to be hospitalized for dehydration than people aged 65-69.  Dehydration is fatal in 18% of these cases, not having been addressed early enough. Most importantly, this problem can be prevented. Knowing the signs and having a plan can help prevent this very common problem.

Signs:

• Confusion - Frequently an early sign. Pay attention to even mild cognitive changes.
• Poor skin turgor-  May be difficult to assess, but skind that feels warm and moist may be a good sign.
• Dry mouth
• Changes in vital signs - Usually a lower blood pressure and an increase in pulse.
• Concentrated urine
• Dizziness or fainting

Risk Factors:

• Increased age - The elderly have lower body water content compared to younger people.
• Cognitive impairment - Difficulty remembering when or how much fluid they have had to drink
• Medications - Diuretics, laxatives, blood pressure medications, some demetia medications
• Dysphasia - Difficulty in swallowing
• Decreased ability to sense thirst
• Increase in activities
• Depression
• Change in schedule
• Diarrhea

Prevention strategies for caregivers:

• Make monitoring fluid intake a priority
• Know the signs and symptoms
• Offer water every hour; even when the elder does not say they are thirsty
• Add lemons, strawberries, orange slices, or cucumbers to make water more appealing
• Offer food like, jello, yogurt, melons
• Make water available at all times especially if going on an outing, walk, or running errands
• Pay attention to temperature changes

Water is a basic nutrient of the body and is critical to human life, supporting digestion, the transport and use of nutrients, and the elimination of toxins and waste from the body (Kleiner, 1999). Let us remember to pay attention, and help prevent this big problem in the lives of the elderly.