Before You Forget, Read This Guide About Dehydration in Seniors

Dehydration can occur in any healthy person regardless of age or gender. Dehydration in the elderly can sometimes be more difficult to manage and prevent. The reasons why include dulling thirst sensations, changes in physiology, and the need for medications which may also play a role.

It becomes increasingly important to maintain proper levels of hydration as we get into older ages. Elderly dehydration can become an emergency situation if it becomes severe enough. In this article, we’ll discuss all of the warning signs, recommendations, and what you can do to prevent becoming dehydrated in the first place.

What Is Dehydration??

Water is the chief fluid in our bodies. It serves a vital role in our digestive systems by helping to transport nutrients from the foods we eat.

Water is responsible for aiding in the removal of toxins from our bodies. Water also regulates our body temperatures and helps to lubricate our joints. Because fluids cannot be stored, they must be replaced on a daily basis.

When our bodies do not have the necessary water and fluids, we become dehydrated. There are different levels of dehydration which are categorized as mild, moderate, and severe. Mild dehydration is usually not dangerous. Severe dehydration can be life-threatening and needs to be treated as a medical emergency.

Why the Elderly are More Prone to Dehydration

There are a few reasons why seniors are more susceptible to dehydration than those who are younger. Our sensation of thirst starts to dull and become less noticeable as we age. Our water and sodium balance also begins to change.

The elderly tend to have more impairments. Because of handicaps or disabilities, it may be more difficult to access fluids as often as they are necessary. Certain medications also have certain side effects which may cause dehydration in the elderly.

Changes in Physiology

There are four ways in which aging can alter water physiology.

  • A decrease in the concentrating ability of the kidneys
  • Less efficient arginine vasopressin (AVP)
  • Decrease in total body water levels
  • Altered sensations of thirst

Signs and Symptoms of Dehydration

Thirst is usually one of the first dehydration symptoms in the elderly, but there are numerous other warning signs. A few of these signs include:

  • Headache
  • Fatigue
  • Weight loss
  • Darker colored urine
  • Increase in heart rate
  • Lowered blood pressure
  • Sunken eyeballs
  • Less frequent urination
  • Dry mouth and dry eyes
  • Constipation

Some seniors also may find that they feel lethargic, confused, or weak as a result of dehydration

Causes of Dehydration

Dehydration in the elderly can usually be a result of very common reasons. Sometimes seniors are busy or just forget to take in enough fluids. In other instances, being sick can limit food and fluid intake. If seniors are out of the house for an elongated period, they may not have had access to water wherever they were.

Other symptoms of dehydration in the elderly may include:

  • Diarrhea and vomiting – Each of these can result in a rapid loss of both fluids and electrolytes in a short period. If the fluids are not replaced, dehydration can occur quickly.
  • Excessive perspiration – When you sweat, you lose water. Hot climates and exercise can both cause higher rates of perspiration. Fluids need to be replaced, or dehydration will occur.
  • Fever – A general rule is that the higher a fever becomes, the quicker you can dehydrate. If the fever includes diarrhea or vomiting, fluids can be lost even faster.
  • Increase in urination – An increase in urination can happen for various reasons. Diabetes that is undiagnosed or uncontrolled is one possibility. Diuretics and blood pressure medications may also lead to increased urination which can cause dehydration.

Why Is Hydration So Important for Seniors?

Numerous bodily functions rely on our being well-hydrated. Dehydration in seniors can cause the functions of cells and organs to be less optimal.

Water Is Vital for Bodily Function

The human brain and heart are composed of 73% water. Water hydrates all of our cells and organs. Although hydration alone cannot keep our cognition sharp forever, it can help to ensure that our bodies function up to their capabilities.

Intestinal Function

The elderly often have issues with constipation and bowel movements. Inadequate intake of fluids is generally pinpointed as a contributing factor to constipation. Increasing fluid intake is usually one of the first things recommended to remedy the situation.

Urinary Incontinence

Many seniors struggle with incontinence issues. A common misconception is that drinking more fluids will lead to more frequent urges and make the issue worse. Not only can lessening fluid intake make incontinence worse, but it can also result in dehydration in seniors. You should not restrict your fluid intake when dealing with urinary incontinence.

Preventing Dehydration in the Elderly

First and foremost, seniors should aim to consume at least 1.7 liters of fluids every 24 hours. Setting a reminder may help. Most phones have these capabilities now. If you do not have access to a device that can set reminders, it may help to enlist a family member or caretaker to take on those responsibilities.

Water and healthy drinks should be available to the elderly at all times. They should be encouraged to consume them throughout the day. A key to staying sufficiently hydrated is to balance smaller amounts of fluids throughout. It is not advisable to consume significant amounts at once.

During periods of warmer weather, it is important to remember that fluids can be lost at a faster rate. In any scenario where fluids are lost faster than normal, they must be replaced as such. If for any reason, the recommended amounts cannot be met, receiving them intravenously may be necessary.

Are 8 Glasses of Water per Day Necessary?

For many years, one of the general rules of thumb for water consumption were eight 8 oz glasses of water per day. This rule originated in 1945 when the U.S. Food and Nutrition Board recommended 2.5 liters of fluid consumption per day. It was mentioned that a significant portion of this quantity could be found in foods consumed throughout the day. Especially fruits and vegetables.

It is not necessary for the entirety of our recommended daily fluid intake to come from drinking exclusively. A balanced diet will include the equivalent of approximately two to three 8oz glasses of water through food intake. Soups, puddings, and gelatin are all examples of foods that have high water contents. Dry foods such as cookies and snack foods have a lower moisture content.

Research and Findings

A study published in 2002 concluded that the old recommendation for eight 8oz glasses of water per day was not necessary. The study has been issued in the American Journal of Physiology, and the researcher’s name was Heinz Valtin.

The findings of the study also revealed that simply drinking when thirsty would be an adequate way to remain hydrated. While this is a relatively easy rule to go by, it could prove much more difficult for seniors who have diminished thirst sensations. Though caffeinated drinks aren’t a recommended way to hydrate, they do count.

The Institute of Medicine (IOM) released recommendations in 2004 that agreed with the findings of Valtin. Other exceptions to their rule for drinking when thirsty includes those with medical conditions or those living in much hotter climates.

Summing It All Up

The amount of fluids we need on a daily basis can vary between people. Dehydration in the elderly may occur more quickly due to various factors. Seniors can be especially prone to becoming dehydrated and may miss some of the warning signs, so it is of particular importance to learn them and take the proper preventative measures.

Have you had any personal experiences with dehydration or have any tips on how to avoid it? Be sure to let us know in the comments section below!

Sean Byers, MD

Sean Byers, MD

Sean Byers is currently a Resident in the Internal Medicine program at UTMB. He studied at the University of Queensland School of Medicine as well as received his Master’s in Public Health with a focus in epidemiology and biostatistics at the University of Southern California. His background is in biology, computer science, public health, and internal medicine.

Recommended Articles