Anyone can become dehydrated, however older people are much more susceptible to dehydration than younger people. This is partly due to lack of thirst sensation and changes in the water and sodium balance that naturally occur as people age. Here we explain how to spot the signs and symptoms of dehydration and give tips on how to reduce dehydration in the elderly.
Dehydration in elderly people can cause significant health problems, including mental dysfunction, for example delirium, and cognitive issues. According to a study conducted in 2019 by the International Journal of Preventative Medicine between 6% and 30% of people aged 65 years and older who are admitted to hospital are dehydrated, largely caused by insufficient fluid intake. Among this group the fatality rate from dehydration can rise as high as 50%.
What is dehydration?
Dehydration happens when your body uses or loses more fluid than you take in and therefore does not have enough water to carry out its normal functions. For older people they naturally have a lower volume of water in their bodies and certain medications and existing health conditions can increase the risk of them becoming dehydrated.
Dehydration in elderly can increase the risk of several health complications, including bladder infections, respiratory infection, fever, low blood pressure and kidney stones, to name a few. It is therefore very important to prevent dehydration in elderly people as much as possible.
There are several factors that make dehydration in elderly more prevalent. Certain environmental factors play a part, for example excessive heat which can cause bodily fluids to reduce through the natural sweating process, and in some cases causes heatstroke. Common illness and sickness with symptoms like fever, diarrhoea and vomiting can cause dehydration in elderly. Many health conditions can cause you to lose more fluid than normal, for example diabetes and kidney disease.
Risk factors associated with dehydration
A reduced sensation of thirst
This is common in older people and more so for those living with specialist conditions, like dementia or for those who have suffered a stroke.
Reduced renal function
The kidney’s play a key role in regulating fluid, but as we age their function deteriorates, and the bodies hormonal response, which is critical to balancing fluids, may be impaired.
There are a few medications that can exacerbate dehydration, the most common being diuretics and laxatives commonly used regularly by many older people.
Dementia and other cognitive impairment
Those living with dementia who are experiencing changes in functional ability, like swallowing are more at risk of becoming dehydrated.
If a person living with diabetes and is not controlling their condition well, this can increase the risk of dehydration.
Poor fluid intake
Inadequate fluid intake is a significant factor in dehydration in elderly. Poor fluid intake can happen due to a person’s decreasing independence as they age. The inability to feed and take on fluids independently and being able to access the fluids they need all increase the risk of dehydration. In residential care and nursing homes this can be exacerbated due to lack of awareness by care teams as to the importance of regular hydration in the elderly.
Those who have problems with continence may be more reluctant to take on necessary extra fluids, particularly at night or leading up to going to bed.
As older people are prone to depression and feelings of low mood, they can lose interest in maintaining a healthy hydration routine.
Signs of dehydration in elderly
It is important if you are caring for an older person to recognise the signs of dehydration, whether you are looking after a loved one at home, are a carer providing home care or are working in a residential setting caring for elderly people.
The most common symptoms of dehydration in elderly include:
- Dryness of the lips, mouth and tongue
- Skin dryness and inelastic skin
- Sunken eyes
- Low blood pressure
Urine can provide insights into a person’s hydration state. Reduced urine and concentrated output are signs of dehydration. Also, the colour of a person’s urine can be a guide as to signs of dehydration in elderly. A strong-smelling dark urine is very common if a person is dehydrated, and an odourless and pale urine indicates good hydration.
The challenge here is that most of the signs of dehydration in elderly are common in other conditions that they may be living with. The key is to monitor closely fluid intake to ensure a good hydration routine and keep an eye on changes in passing of water. Severe dehydration can cause a serious medical emergency that may require a hospital visit or stay, so it is really important to monitor closely.
Preventing dehydration in elderly
Whether you are an older person or you are caring for one, there are several steps you can take to prevent dehydration in elderly:
- Regularly drink water or other beverages throughout the day. Whilst water is by far the best liquid to keep you hydrated, there are a number of other drinks that are good for preventing dehydration in the elderly, including milk, fruit juices (only those low in sugar), sparkling water and flavoured squash. Coffee and tea can have diuretic effects so should be drunk in moderation.
- Whilst older people should try to drink 1.75 litres of fluids a day, this can sometimes feel an overwhelming amount to consume, so take small sips and drink regularly throughout the day. If drinking lots of water is unappealing to you, add a slice of fruit to give it flavour.
- Introduce foods in your diet with a high-water content, including strawberries, cucumber, watermelon, celery and soups (only those low in sodium).
- Always plan to drink water if you are going out – take a water bottle with you wherever you go.
- If you are exercising it is critical that you replenish any fluids you disperse through sweat, so make sure you have that all important water bottle topped up.
- Be aware of your environment – if it is a hot day or you are in a warm environment be sure to have access to constant fluids.
- If you are unwell and experience vomiting or diarrhoea it is important for you to drink plenty of water to replenish.
- Should you be living with an underlying health condition, consult your doctor about your specific fluid requirements to ensure your hydration needs are met.
Consequences of dehydration in elderly
If left untreated there are serious consequences of dehydration in the elderly that will require immediate medication attention.
Serious symptoms of dehydration in elderly include:
- Rapid heart rate
- Trouble with mobility and risk of falling
- Confusion and disorientation that can result accidents or falls
- Diarrhea or vomiting that lasts longer than 24-hours
If these symptoms are left untreated, it can cause serious consequences including:
- Urinary tract infections (UTIs)
- Kidney problems, including kidney stones or even failure
- Seizures due to low potassium and sodium levels in the body
- Hypovolemic shock caused by a drop in blood pressure and oxygen levels – this can be a life-threatening consequence of dehydration
- Heat exhaustion and heat stroke
How The Good Care Group can help the elderly and dehydration symptoms
We have been providing high-quality live-in care services to families across the country for over 10 years. At the heart of our service is enabling people to live an improved quality of life, with the care and support they need from a carefully well-matched, trained professional carer whose focus it is to enhance health and overall well-being.
Live-in care enables older people to live in the safety and comfort of their own home with highly personalised one-to-one care – something even the very best residential care homes simply cannot provide. Care provided by dedicated carer who truly understands and monitors your hydration needs can prevent dehydration in the elderly and significantly reduce unnecessary hospital admissions.
Expertly trained care teams
Our industry leading training programme, which includes modules on food, hydration and nutrition, has been created with leading charities and clinical experts and goes well beyond industry standards. This enables our professional carers to support a range of conditions affecting older people, including those complex conditions that require more monitoring, care and support and can result in symptoms of dehydration in elderly. Carers are trained to effectively manage medications, identify side effects including dehydration and prevent dehydration in elderly people.
Compassionate and supportive carers
Carers are on-hand around the clock to remind clients to hydrate throughout the day, especially at mealtimes and after any exercise or exertion. They will ensure water is kept in places where it is accessible and easy to reach. They will sensitively support clients personal care ensuring they have regular and easy access to the bathroom when drinking increasing levels of fluids.
High quality dementia care at home
All our professional carers are trained in how to care with someone living with dementia and use a range of best practice dementia care techniques proven to provide reassurance, reduce anxiety and calm behaviours. They can effectively manage hydration and prevent dehydration, so commonly experienced by those living with dementia. This means the person with dementia can live well at home, despite the challenges dementia can present with the proactive and gentle encouragement provided by our dementia carers.
Improving dehydration in elderly using technology
At The Good Care Group every decision is driven by delivering improved health outcomes for our clients. Through our dedicated and committed approach to providing high quality care to our clients and the use of our market-leading digital technology, we see significant improvements in our clients’ overall health and wellbeing every year.
Unique to the live-in home care market, the technology enables us to digitally monitor health outcomes allowing us to effectively predict risk of dehydration in elderly and shape the care we provide. We know, for example that urinary tract infections (UTI’s) are one the of the leading causes of hospital admissions for our clients, so we equip our carers with handheld testing kits to proactively monitor our clients for infections. We then benchmark our data to demonstrate how effective our care is in improving the quality of our client’s lives in the context of other types of care provision, for example care homes.
Unrivalled falls prevention programmes
We know that people are more likely to suffer a fall if they are dehydrated, so our approach to monitoring and managing hydration means our clients are seven times less likely to suffer a serious injury because of a fall than residents living in a residential care home.
Working with our in-house Occupational Therapist, we identify clients who are ‘frequent fallers’ and through an intensive and personalised approach to falls management these clients experienced 47% fewer falls from being in our care.
Reducing urinary tract infections (UTIs)
UTIs are one of the most common signs of dehydration in elderly. Through enhanced training and the use of our market-leading digital technology, our professional carers can perform urinalysis tests. This means they can provide accurate and timely information to GP’s, enabling a quick diagnosis and treatment.
82% of our clients were diagnosed in 2019 using urinalysis kits, and through the introduction of testing we were able to reduce emergency interventions involving a 999 call or ambulance call out by a staggering 63%. We have also achieved a 22% reduction in overall UTI related hospital admissions.
Proactive monitoring of chest infections
Our partnership with an award-winning technology provider, Feebris has seen us reduce hospital admissions for those with respiratory problems by 28%, one of the symptoms of dehydration in elderly. Our carers use handheld medical devices to detect early signs of illness, such as chest infections enabling timely intervention to avoid unnecessary hospital admissions.